Sunday, April 22, 2012

The Truth of the Matter

About a week ago, I was having lunch with some friends (most of them in med school with me). I can't recall how, but we arrived on the topic of "conventional" vs "alternative" medicine.

We had all read at least some excerpt of Anne Fadiman's book, The Spirit Catches You And You Fall Down. It's a biography of a Hmong girl who develops seizures and about the divide between Hmong culture and and Western medicine culture. Interestingly, my friend and I took away very different messages from the book.

He cited a quote from a surgeon towards the end of the book saying to the effect, "Western medicine works" and claims Fadiman ignores that fact and moves on. He believed that all of the alternative medicine and cultural beliefs of the Hmong in the book were essentially crap and that Western medicine was the one true solution to the girl's seizures, and that everything else got in the way. Western medicine is the only thing that works. I disagreed on two points: 1.) it doesn't really matter if Western medicine is superior or not if the patient doesn't want to take it, 2.) not all alternative medicine is necessarily crap - a lot is just unproven medicine.
1. The truth of the matter is, patients don't always think highly of doctors. It's our fault, really. Doctors can be so dismissive and so readily "reduce" patients to numbers, diseases, and organs. We can appear cold and disengaged. It doesn't matter if Western medicine is the only thing that works - if patients don't take the medicine we give them, the effect of our medicine is zero. We must negotiate without patients, we must compromise with our patients, we must work with our patients to get them the best medical care possible.

There's a great article written on (a great medicine/health blog) titled, Stop the Us versus Them mentality in medicine, that speaks very well to this point.

2. The truth of the matter is, not all alternative medicine is crap. A little over decade ago, acupuncture was scoffed at as a sham and now it's routinely used as an adjunct to treat pain and some other conditions. Though the research on acupuncture can be argued as not being the most rigorous and powerful out there, it did demonstrate real potential. Garlic has some medicinal properties and so does St. John's wort.

Herbal medicines and teas can augment or interfere with the effects of our conventional drugs. It behooves us to know what these herbals may do, so we may advise patients accordingly. More research needs to be done. There a lot more alternative medicine out there than research is able to elucidate its true effects. There's a lot of untapped potential that needs to be refined into a product that can reliably and safely work - to disregard it all as "for hippies" or "essentially placebo" is a disservice to patients and the spirit of science and medicine.
Another friend at lunch remarked, "Do you know what alternative medicine that's proven to work is called? Medicine." I disagree somewhat. There's a difference between the word "alternative" and "integrative and complementary." Not too long ago research showed that a tablespoon of honey in a cup of hot water helped temporarily relieve symptoms of sore throat and cough. But these things alone usually can't suffice, and hence are integrative and complementary. Alternative implies a divergence from conventional medicine.

This article, The Believers, that my friend sent me yesterday unsettles me a little. It may seem hypocritical of me to say that, given what I've argued above. But I am by training a scientist. I acknowledge that there is a world outside what research has touched (because if research has touched it all, there would be no further research). I believe that many alternative therapies warrant further scientific research to see if it truly works or not.

Anyway, the truth of the matter is, we shouldn't dismiss alternative medicine so readily because we don't always have proof it doesn't work. Also, if we dismiss it so readily, patients may take offense and refuse to take the medicines we prescribe. And if they don't take our medicines, that have research backing that they work, then what's the end effect? Oh yeah, nothing.


naturgesetz said...

I agree that some if these alternative remedies may work. Recently a relative e-mailed me an article about asparagus as a cure for cancer. The evidence is anecdotal, and I don't understand why the stuff needs to be pureed, unless it's just to avoid the expense of taking more than is necessary. But I like asparagus, and I hope it's doing me some good.

The article is long, but here it is.

Asparagus -- Who knew?
From a friend –
My Mom had been taking the full-stalk canned style
asparagus, pureed it and took 4 tablespoons in
the morning and 4 tablespoons later in the day. She did
this for over a month. She is on chemo pills for Stage 3
lung cancer in the pleural area and her cancer cell
count went from 386 down to 125 as of this past week.
Her oncologist said she will not need to see him for 3

Several years ago I met a man seeking asparagus for a
friend who had cancer. He gave me a copy of an article,
entitled "Asparagus For Cancer" printed in the
Cancer News Journal, December 1979. I will share it
here, just as it was shared with me: I am a
biochemist, and have specialized in the relation of diet
to health or over 50 years. Several years ago, I learned
of the discovery of Richard R. Vensal, D.D.S. that
asparagus might cure cancer. Since then, I have worked
with him on his project. We have accumulated a number
of favorable case histories. Here are a few examples:

Case No. 1, A man with an almost hopeless case
of Hodgkin's disease (cancer of the lymph glands) who
was completely incapacitated. Within 1 year of starting
the asparagus therapy, his doctors were unable to
detect any signs of cancer, and he was back on a
schedule of strenuous exercise.

Case No. 2, A successful businessman, 68 years old,
suffered from cancer of the bladder for 16 years.
After years of medical treatments, including radiation
without improvement, he began taking asparagus. Within 3
months, examinations revealed that his bladder tumor
had disappeared and that his kidneys were normal.

Case No. 3, On March 5th 1971, a man who had lung
cancer was put on the operating table where they found
lung cancer so widely spread that it was inoperable.
The surgeon sewed him up and declared his case
hopeless. On April 5th he heard about the Asparagus
therapy and immediately started taking it. By August,
x-ray pictures revealed that all signs of the cancer had
disappeared. He is now back at his regular business

Case No. 4, A woman had been troubled for a number of
years with skin cancer. She developed different skin cancers
which were diagnosed by the acting specialist as advanced.
Within 3 months after beginning asparagus therapy, the skin specialist said her skin looked fine with no more skin lesions. This woman reported that the asparagus therapy also cured her
kidney disease, which had started in 1949. She had over 10
operations for kidney stones, and was receiving government disability payments for an inoperable, terminal, kidney condition.
She attributes the cure of this kidney trouble entirely to the asparagus treatment.

naturgesetz said...

It was too long for a single comment. Here's the rest.

I was not surprised at this result as `The elements of
materia medica', edited in1854 by a Professor at the
University of Pennsylvania , stated that asparagus was
used as a popular remedy for kidney stones. He even
referred to experiments, in 1739, on the power of
asparagus in dissolving stones. Note the dates!
We would have other case histories but the medical
establishment has interfered with our obtaining some
of the records. I am therefore appealing to readers to
spread this good news and help us to gather a large
number of case histories that will overwhelm the
medical skeptics about this unbelievably simple and
natural remedy.

For the treatment, asparagus should be cooked
before using. Fresh or canned asparagus can be
used. I have corresponded with the two leading caners of asparagus, Giant and Stokely, and I am satisfied that these brands contain no pesticides or preservatives. Place the cooked asparagus in a blender and liquefy to make a puree. Store in the refrigerator. Give the patient 4 full tablespoons twice daily, morning and evening. Patients usually show some improvement in 2-4 weeks. It can be diluted with water and used as a cold or hot drink. This suggested dosage is based on present experience, but certainly larger amounts can do no harm and may be needed in some cases.

As a biochemist I am convinced of the old saying that `what
cures can prevent.' Based on this theory, my wife and I
have been using asparagus puree as a beverage with
our meals. We take 2 tablespoons diluted in water to
suit our taste with breakfast and with dinner. I take
mine hot and my wife prefers hers cold. For years we
have made it a practice to have blood surveys taken as
part of our regular checkups. The last blood survey,
taken by a medical doctor who specializes in the
nutritional approach to health, showed substantial
improvements in all categories over the last one, and
we can attribute these improvements to nothing but
the asparagus drink. As a biochemist, I have made an extensive study of all aspects of cancer, and all of the proposed cures. As a
result, I am convinced that asparagus fits in better
with the latest theories about cancer.

Asparagus contains a good supply of protein called
histones, which are believed to be active in controlling
cell growth. For that reason, I believe asparagus can
be said to contain a substance that I call cell growth
normalizer. That accounts for its action on cancer and
in acting as a general body tonic. In any event,
regardless of theory, asparagus used as we suggest, is
a harmless substance. The FDA cannot prevent you
from using it and it may do you much good. It has
been reported by the US National Cancer Institute, that
asparagus is the highest tested food containing
glutathione, which is considered one of the body's
most potent anticarcinogens and antioxidants.

Just a side note... In case you are wondering why this has
not been made public, there is no profit in curing cancer!

Mike said...

Most doctors tend to brush me off/talk down to me. I admit i don't have a lot of respect for doctors until they prove to me that they care/are human. The allergist last week was great- she cared. The allergist before her talked down to me and I didn't appreciate that.

. said...

I think alternative medicine should have a role in the doctor community. But I seriously have little faith that a lot of doctors would openly support that notion because of the lack of real benefit they see from it. It's like some doctors really care to help you and others are just in it for the money or a sense of power. Maybe I'm wrong. I don't know...

Aek said...

naturgesetz: That's interesting, but case studies don't offer much evidence. That said, nothing wrong with asparagus (though I doubt it can prevent/cure cancer on its own).

Mike: Depends on the doctor and the medical field. Some docs are way more rushed than others. And surgeons have a particular reputation.

.: Doctors don't need to openly support alternative medicine (nor should they necessarily advocate for it), but acknowledge that patients use them and find a way to negotiate between that and conventional medicine. Doctors aren't trained in alternative medicine and thus can't in good faith promote it.

There are as many kinds of doctors as there are people in this world. Not all people are altruistic caring people, and doctors as a population reflect that reality. That said, there are (in general, I think) more altruistic and caring doctors compared to the general population.