Multiple models of medicine?

In My Humble Opinion
1

Disclaimer: I don’t expect you to be a doctor. I think some of you have nursing or related experience and I’m particularly interested in those opinions. In any case, though, I’m not going to be taking names or using any of this as court evidence.

An old girlfriend was recently diagnosed with lung cancer. I’m not sure what stage it’s at, but it seems severe enough that she called me about it even though we’ve been estranged for a long time.

Not to worry, says my martial artist friend. He’s a sports therapy consultant who has studied chi gong, reiki, crystallography, aromatherapy, and acupuncture. He’s sure he can apply various herbs, smokes, oils, and energy fields that will completely cure my sister’s lungs. Half the battle, he says, is convincing the mind and body that it doesn’t have to put up with the malady and telling the disease that it’s not welcome in your body.

I’m a martial artist, too. I’m familiar with the theories (and some usage) of chi/ki energy. I’ve worked at health food stores and fitness clubs and I’ve seen the naturopathy, homeopathy, aromatherapy, and essential oils stuff come and go and come again. In the late 1970’s I dabbled in pyramids and crystals and numerology and astrology and psi/psychic phenomena. I’ve successfully completed chiropractic, acupuncture, and Chinese herbalism treatments and I’ve come out of those feeling better and truly healed.

My view of pharmaceutical science is that it starts with those ‘magical’ herbs, oils, and smokes to strip away the unnecessary or counterproductive ingredients and isolate the active ingredients that address medical problems. Then they establish proper dosages, treatment regimens, etcetera. This means I’ve become pretty convinced that alternative medicines are not refined enough in their methods to handle cancer, brain damage, or lung disease.

But that’s the problem. I’m pretty convinced [but not necessarily fully-convinced] by the “Western Scientific model” of medical research and treatment but I also have some limited (or perhaps even more-than-normal) exposure and experience with “competing paradigms” of health care and recovery management. I think this is putting me squarely on-the-fence about whether or not it’s appropriate for my martial artist friend to provide treatments that purists would probably be quick to dismiss as witchcraft or voodoo.

So…

  1. Who are you (if some sort of background or credential may seem relevant)
  2. What do you think of applying “alternative approaches” …
    A) Instead of Western Medical treatments
    B) As a supplement to Western treatments
    …to such a serious malady?
  3. Is the guy offering to help at risk of breaking any laws or professional regulations (medicine or Physical therapy without a license, etc) if he does his thing (with or without consent).

Let the turbulent discussions begin…
—G!
Just what you need to make you feel better
Just what you need to make you feel…
…–Jack Harris (Alan Parsons Project)
…(The System) of Dr. Tarr and Professor Fether
…Tales of Mystery and Imagination

2

Stripped of the nuance, the “Western Scientific Medicine” (which is also the everybody else’s scientific medicine) process consists of:

  • try something a bunch of times, generally in isolation
  • keep track of ALL of the results
  • if it works better than chance, keep it. If not, discard it.

The “alternative medicine” process consists of:

  • try a whole bunch of things, generally all at once.
  • keep track only of the successes
  • if it doesn’t work in a given case, hand-wave it away. If it does work, assume that all the hokum was right, and that chance couldn’t possibly be responsible.
  • spend a lot of time explaining why it’s not reasonable to perform the western scientific medicine process on your process, and
  • explain that it’s not necessary because you just KNOW it works, anyway.

Which one do you want?

3

You know what they call alternative medicine that works? Medicine. Real doctors would love to have something that was more effective against cancer than what we’ve got, even if they didn’t understand how it worked.

Your friend would probably have better luck going out into the middle of the rainforest and just trying plants at random, than she would using “alternative medicines” recommended by a “sports therapy consultant”. There’s at least a chance that she might find something effective that way, rather than trying things that have already been tried and found wanting. And in the likely event that nothing worked there, either, at least she’d get a fun vacation out of it before she died.

And wait a minute-- Is it your ex-girlfriend, or your sister, who’s sick? It seems to me that it’d be kind of hard to mix those two up.

4

I practiced martial arts for a long period of time.

You know what alternative medicine I found works really well?..

Extra strength tiger balm on a nasty bruise. Especially if you rub it hard until the skin feels really hot from friction.

For everything else, I’d see a (western) medical doctor.

5

Medical doctor here.

Use the proven medications first. While I would not have a problems with adding in things like accupuncture or massage or aromatherapy which might make a patient feel better while undergoing conventional treatment, keep in mind that they can be expensive and their benefit will be purely psychological.

I would not recommend herbs since they can interact with conventional medication and I cannot believe that “smokes” would be anything but bad for a lung cancer patient.

I would stay far far away from any “sports therapy consultant” who claims to cure cancer.

6

I’m a biology PhD student, for what it’s worth, but that’s not really relevant to what I’m about to say. I’ll also acknowledge up front that this is an anecdote, rather than data, but it powerfully illustrates an important point.

A lot of people claim that alternative medicines are generally harmless and should be looked at with indulgence. Generally speaking, I tend to go along with that (which may surprise some here). If you want to clutch and crystals and wave your hands around, go for it, as long as you’re not preventing anyone else from getting actual REAL help.

That said, my parents’ neighbor was diagnosed with testicular cancer a few years back. Scary, but as they say, if you’ve got to have cancer, this is a good one to get. Medicine can cure testicular cancer pretty well. The success rate is one of the highest of all cancers, and they caught his early enough that it should have been close to a slam-dunk.

However. His wife was big into woo, and insisted that he try, oh, anything and everything she could think of instead of actual treatment. My parents watched this guy, who was in middle age, with four young children, gradually decline over many months. Every time they asked about his health, it was the same. “Oh, we just found this new naturopath/homeopathicist/aura cleanser/crystal healer/whatever, and he/she’s making a world of difference! We’re sure this will do the trick, and he’ll be back on his feet in no time!” Over and over and over again, jumping from one wad of nonsense to another.

Toward the end, when he clearly had days left to live, my dad offered to watch him so that his wife could have a break. She left him with a variety of teas and poultices to give him for his pain, which was clearly beyond intense. As soon as she left the house, my dad dug out the poor guy’s prescription painkillers and gave him the maximum dose on the bottle, giving him his first real relief in who knows how long.

Those four kids are now fatherless, being raised by their mother, who, last I heard, was supporting herself by selling theraputic magnets.

Alternative medicine isn’t harmless. It can kill.

So, of your options, I guess I say go ahead and use it if it makes you happy, but do NOT let it replace actual, real treatment.

7

Well your friend is wrong - zero of the battle is about convincing the mind/body that the cancer isn’t welcome. Anymore than convincing a fire not to consume (or a body not to be consumed) if that body was left in a fire.

Positive thoughts do not cure cancer. There is no convincing research to suggest they do. People like to tell them they are “fighting against” cancer - and If that makes them feel better so be it. It won’t help their cancer.

http://www.cancer.org/treatment/survivorshipduringandaftertreatment/understandingrecurrence/whenyourcancercomesback/when-cancer-comes-back-positive-attitude

Science tries stuff - sees if it works - uses what does and refines the cycle.

The other stuff starts with some theory - and then believes this theory works - ignoring evidence to the contrary.

The fact that your friend believes in the positive woo based feeling approach means he is totally incapable of making reasoned logical choices. Ask him what studies he has to support this - and he will either come back with BS studies that were done in a BS “journal” - or he will claim it is hard to measure - studies don’t matter.

The thing is these types of studies ARE easy to do and easy to measure. If they worked as well as the proponents claimed - it would easily show up in repeated studies. They almost never do work.

Medicine is only using the stuff that has been proven to work. You can easily spend your time on stuff that doesn’t, and MAYBE they will - but that is wishful thinking.

8

Ther is a LOT more to it than that, and not just nuance. Indeed, I think most medical researchers (and doctors, come to that) might be quite insulted by that as a characterization of what they do. All those years of learning about anatomy, physiology, biochemistry, microbiology, etc., were wasted, so it seems, along with all the research that goes on, in the name of medicine, in all those fields.

No, “Western Scientific Medicine” is not, and has never been, about trying stuff at random and seeing if it works, and if it were it would not have advanced much (if at all) since Ancient times.

And, of course, what makes “alternative medicine” mostly ineffective or even dangerous is mainly the fact that it is not rooted in the knowledge about the human organism, and disease organisms, that we get from the study of such sciences as anatomy, physiology, biochemistry, microbiology, etc. “Alternative” practitioners can do “try it and see if it works” as well as a real scientist can. But that is not nearly enough for a way of finding effective cures.

9

Your old estranged girlfriend is also your sister?

10

TimeWinder’s summary was, obviously, oversimplified. How could it not be, without taking up more space than the entirety of this message board?

As a sharp, sardonic, and saucy thumbnail of the real issue at hand, it was brilliant. One of the best summaries of the pseudo-debate ever seen. Funny, too.

11

Not oversimplified, no. False and highly misleading. If Western Medicine, and scientific research in general really worked like that then, “alternative medicine” could indeed, with not much effort, make itself just as “scientific”.

I would venture to say that that the prevalence of that sort of false, cartoony view of science is precisely the sort of thing that allows pseudoscientists to convince themselves that what they do is just as good, or better.

And it did not take me anything like “the entirety of this message board” to say so, either.

12

You’re beating a toy horse. The post was oversimplified, deliberately.

It was clever, witty, and wise. You’re demanding textbook language from a debate thread.

13

By the way…

Cute, but bullshit. I said it would take that much space to define the difference between real scientific medicine and the psuedoscience of most alternative therapies publicly espoused today. You did nothing of the sort; you only exposed the shortcomings in someone else’s debate post. Fail.

14

This board is not kind to alternative medicine, so do bear that in mind.

However, cancer (except perhaps slow growing prostate cancer) is one area in which I agree with the hostility.

My background: Trained 3 years in Traditional Chinese Medicine, including tongue and pulse diagnosis, energetics of herbs and meridian/qi theory. Trained for 5 years in Western Herbalism, with an herbalist who is a licensed acupuncturist and practitioner of TCM, as well as a professional member of the American Herbalists Guild - she, and I, combine the energetics and diagnostic system of TCM with the herbs that we can grow, harvest and make medicine with here in the US. Trained in medicinal aromatherapy and perfumery. I’m a certified massage therapist (although I’ve let the license lapse) trained in shiatsu, Swedish and deep tissue techniques. Trained in several energetic healing techniques from Eastern and Western schools of thoughts, including one in particular I’m fond of passed down through the Golden Dawn. I’m *also *a Registered Nurse, trained in a mainstream “western” nursing program in the US. I’m 6 credits shy of a degree in Nutritional Science. So, bottom line, I straddle both worlds.

My thoughts: use what’s needed, where and when it’s needed. This usually breaks down nicely by acuity and expected rate of decline. Herbs and energetic techniques work slowly. They work to heal roughly as quickly as it took the person to get unwell. They tend to work really well for long term, chronic conditions like sinusitis or seasonal allergies They work reasonably well for mild infections, recurrent skin rashes/eczema/psoriasis, chronic aches and pains, and colds (which, coincidentally, are the things that “western medicine” is pretty crappy at.) If you have a very dedicated client who will follow the plan of care (which is rare), they work fairly well for management of metabolic disorders like diabetes (although I still want blood sugar monitoring and A1C’s to monitor the severity of the disease, and an agreement up front that we’ll move to pharmaceuticals if this isn’t working), mild depression/anxiety and reducing stress. They totally *suck *at emergency care, broken bones, congenital defects, organs that need transplanting…and cancer.

The biggest problem with using herbs and other “alternative” treatments for cancer is that it delays people seeking effective treatment. And when you delay treating cancer, it gets harder and harder to treat. You just simply don’t have the time required to mess around with cancer.

If you want to put it in language he’ll understand, try it this way: her illness has progressed far beyond the energetic level. This is not a disorder of Yang Qi, easily moved and dispersed by acupuncture, herbs or energetic techniques. This is Yin. This is very Yin, probably very Damp, maybe very Hot, very solid, very physical. To give her enough energy to break up and disperse this Yin Qi, you’d kill her AND the practitioner giving her their energy, even if they’re trained in how to draw Heavenly or Earthly energy and channel it. It’s just not possible to channel this much energy without burning her, and him, entirely out like an overloaded fuse. She needs physical surgery or chemotherapy to deal with this physical problem. Commiserate with him, share his grief that IF this had been caught a year ago when it was energetic in nature, it might have been possible to disperse it then and the cancer might not have formed. But it’s here now in the physical manifestation, and has to be treated with “western” medicine now.

I agree with psychobunny that herbs should generally not be used during cancer treatment - too many herbalists don’t understand the point of chemo, and end up fighting it with their herbs. This is not the time, for example, to give her immune building herbs. Chemo (some chemo) is specifically trying to temporarily lower her immunity in order to kill the cancer. Don’t fuck it up with immune boosting herbs! Other herbs are metabolized using the same enzymes in the liver as chemo drugs, and so if you take herbs that use up enzyme X, the chemo drug that also uses enzyme X won’t be broken down properly - leading to a higher or lower dose of the active drug in her system than the doctor thinks is there. Massage (as tolerated), energy work and mild, gentle aromatherapy (well diluted, nothing ingested) to ease stress and work on her energetic body may be appropriate, but follow her lead and pay attention to the results. This is NOT when it should “hurt so good.”

After surgery/chemo is complete, then you can suggest herbs/acupuncture/energy work to rebuild her body and spirit.

15

One of the advantages of a succinct and simplified explanation is that I can read it over pretty quick and be sure that I never said the first thing about “trying stuff at random.”

I didn’t expect the outrage to be in that direction, but you’d REALLY have hated my first edit of that, which was:

“Western” Science: Keep track of results.
“Alternative” Pseudoscience: Keep track of anecdotes.

16

I’m a firm believer in a holistic approach to what ails you. By holistic I mean addressing all of the person - body, mind and spirit. I am not trained in body healing but think it should be addressed if needed. Actually a team approach seems the best way to address all ailments requiring outside intervention. Besides a doctor, nurses, counselors, social workers, physical therapists, nutritionists all have something to offer to some who, for instance, needs to have a leg amputated.

A few methods which come to mind are medication, surgery, counseling, bibliotherapy, practice of the expressive arts, exercise, creating a healing environment, massage, and other types of touch such as hugging or hand-shaking.

If it doesn’t work then a search needs to be made for what does work in addition to what the doctor can do. Sometimes the patient knows better than the healer what that may be. So getting to know the person you are helping is crucial, I think.

And there needs to be an element of caring involved for ultimate effectiveness. Patients know when a healer is just there to collect a paycheck.

I see no problem with a patient supplementing his Western medicine with reasonable alternative methods as far as that the practitioner is a respected member of his line of work and not someone who is charging exorbitant amounts to fleece his customers.

For instance, I’d put aromatherapy and some types of counseling in this category. There is much to be said for the healing effects of placebo and feeling “fussed over.” If the patient has the money and is getting emotional satisfaction from the experience it’s entirely possible that a frame of mind promoting healing is being created.

17

Witty perhaps, wise no. Misleading and false. The difference between science and pseudoscience is not all about method, and the popular notion that it is is dangerous. Hang your hat on that and the pseudoscientists will win.

You did not read what I said very carefully. I said real medical science is “rooted in the knowledge about the human organism, and disease organisms, that we get from the study of such sciences as anatomy, physiology, biochemistry, microbiology, etc.”. That is what makes for real science, empirically based understanding with a theoretical depth that pseudoscientific medicine cannot come anywhere close to matching, not shallow trial-and-error methodologies. It might indeed take me the “whole board” and more to spell out the details of that theoretical understanding, but I have no need to do that to make my point. You are aware that such theoretical understanding exists, I take it?

No indeed. You did not say anything at all about where the ideas you are supposed to try out might come from (i.e., about the actual science, the hard part that takes years of study to learn, and that actually makes science different from pseudoscience and quackery).

Yes indeed I would have. It would have been, if that is possible, even more misleading.

Quack doctors have been using trial and error methods for millenia. The so called “empirics” of ancient medicine were the biggest quacks of all. The difference between them and modern scientific medicine is not that modern medicine uses better experimental design, more sophisticated statistics, and keeps better records. It does do that, but, even so, Most Published Research Findings Are False (and that is actually about just the sorts of findings you are talking about, empirical, statistically based trials of the effectiveness of various sorts of medical interventions). Quacks (if they had the financing) would quite capable of carrying out statistically controlled, methodologically sound tests of the effectiveness of their treatments, and no doubt would get similar high rates of false-positves to those found by “real” medical testers. That would not, however, make what they were doing scientific medicine. The difference between scientific medicine and quackery is that one is rooted in a deep theoretical understanding of biology, and the other is not. Adventitious differences in the rigor with which treatments are tested is of trivial significance beside that.

18

I am vehemently against any woo in cases of cancer, but recently my aunt-in-law started probably the only option I can get behind.

She’s on an experimental drug that has good results but has such heavy side effects that they do two weeks on, two weeks off. She’s an old hippie, not terribly woo but does believe that “natural is better”. She discussed with her doctor if she could see someone about a diet, and then have him ok the diet. The diet is meant to be supportive, and all it should do is work against the side effects. So for example, this woo dietician gives her what ever he thinks should work against nausea. This plan is then ok-ed by the doctors at the hospital.

She is the only person in the trial who has had no side effects at all, and the first patient who could continue treatment throughout, without stopping between. This has been really beneficial for her. The doctors were also curious about the diet that kept her form vomiting and feeling really tired and such.

I don’t know what flavour of woo this diet is, or what her experimental treatment is. I am just really glad she didn’t go off the deep end and is checking everything with her doc. If it is the diet that is helping then that’s great, if the diet is just helping her feel a modicum of control and she is just immune to the side effects then that’s also cool.

The best thing is, she had cancelled tons of things because she was meant to be feeling so awful. She felt so good she re-scheduled a trip to Valencia with her friends & sister (my MIL)!

(And OP, come back and tell us if you used to date your sister! ;))

19

I am a Ph.D. mechanical engineer, middle-aged. Not formally trained in medicine, but I’d like to think my background affords me some measure of rationality and critical thinking ability.

“Western/Eastern” is a rather arbitary way to divide something as universal as medicine, and “western/alternative” isn’t even a proper dichotomy. I prefer the loaded/biased division of “evidence-based medicine” and “everything else.” The former bases treatment decisions on controlled clinical research into what works, how well it works, how often it work, what the risks/side effects are, and so on. It’s not perfect: when investigating marginally effective treatments for “noisy” diseases that are prone to spontaneous remission and wildy-varying symptoms, small studies can sometimes arrive at erroneous conclusions. But relying on something other than carefully controlled research and analysis of the evidence is far less likely to arrive at an effective treatment.

Using the OP’s “western/eastern” division, the foundation of eastern medicine appears to be “people have been doing it this way for centuries,” and the foundatin of alternative medicine appears to be “this is natural and seems like it should work, and I heard of a guy somewhere who felt better after he used it.” If I’m looking for the best way to treat my disease, I’m going to go with the guy who says “we’ve done several large clinical trials, and for people in your condition, this treatment is effective 85% of the time, with only a 3% risk of serious side effects. No other treatment we’ve studied has been seen to work this well and this safely.”

20

And if it did what would it be?

Western Medicine and scientific research in general really does work like that. In general.

At least the fact that Western Medicine and scientific research do those things is the critical difference between them and what gets lumped under the “alternative” rubric. Yes, members of each model both are more likely to believe and consider things that fit what they think they already know about how things work. So someone who is an alternative medicine person may be more likely to believe something explained by Qi flow because they believe ancients and “other” must have some special powers. And a Western model person may believe something explained by interleukins and T-cell functions because we have models about how those work that we comprehend (and that have successfully explained/predicted other things). The key difference is exactly as TimeWinder succintly put it. Western Medicine and science’s ideal (not always done perfectly in practice mind you) is to keep track of whether the things the models predict actually happen. Thus you try it lots of times, preferably controlling for other confounding factors (“generally in isolation”), and keep track of what actually does and does not work. Then if it did work keep it and keep coming with other ideas as predicted by the model and if it did not work toss the idea and consider revising the model that predicted it. If something works even though it does not fit a model you have then keep the item and revisit the model as well. That’s the idea, as stated by Machine Elf, the goal is to be evidence-based and critically so … practiced a bit imperfectly to be sure.

Timewinder said that idea concisely; I took many more words.

Timewinder’s version was better.