A Quick Note

100K

My hit counter tells me that I’ve had 100,000 unique visits to this blog in the last six months. Add that to the 120,000-or-so visits before I started using Sitemeter and that’s not bad for sixteen months of blogging. Readership is growing and I like to think it’s because I have a lot of well-written articles on interesting subjects which offer a unique insight into the world of medical training that you will not find anywhere else.

It’s either that or the doggy-porn but I’m not complaining.

CAM and Academia

Part of what passes for being open-minded in academia these days is the inability call “bullshit.” This is also known as being so open-minded that your brain either falls out or flaps listlessly in the breeze like a ratty pair of underwear on a line. There is, apparently, very little under heaven, no matter how ridiculous, that some earnest academic, frightened of giving offense, will not either embrace or tolerate even though somewhere, deep down in his crocadile brain a little voice must be shouting at him to grow a spine.

This is because the ethos of the ivory tower is anti-Western, anti-Judeo-Christian, and almost anti-intellectual, at least in the sense that reason and disciplined thinking are subordinate to the latest political fads that periodically sweep through our highly impressionable, somewhat provincial academic community. This is why people who will scoff at traditional religion and impune it’s adherents will never-the-less become extremely reverential when discussing Buddism, Hinduism, and any other religious practice which doesn’t carry the baggage of morality against which they have been conditioned to rebel.

(In regards to Islam, the militant variety of which is antiethical to every principle of liberal Western thought, they are silent either out of fear or because the anti-American strain that pervades it is convenient to their political beliefs. In the the screwy world of academia, you can have liberal, pro-choice professors actively supporting groups like the Taliban who treat women like property, execute dissenters, and would merrily burn their universities to the ground if given the chance.)

The point is that while acupuncture, homeopathy, and other faith-based healing practices will be embraced tightly, faith healing, snake handling, and speaking in toungues, also known as Traditional American Medicine (TAM) will be ridiculed as absurd by the same people who will credulously clap their hands and burn joss to nightmarish asian gods. How some sweaty pastor of a secretive congregation in Arkansas casting out demons through his traditional practice of medicine is different than some svelte intellectual with equally shoddy academic credentials pushing homeopathy or acupuncture is not exactly clear from a strictly rational point of view.

67 thoughts on “A Quick Note

  1. Oh, Panda, I’ve had so many ouch moments reading your post about CAM that I wrote my own thoughts on this controversial issue. You, as always, have my undying respect and you made many valid points. I hope that what I’ve written makes some small amount of sense to you as well. Your blog is among those that brighten my day and will continue to do so. But for a man who is one of the most eloquent writers I’ve ever come across, the acidity of your opinions left me breathless.

  2. “I have opinions.”

    Know that I honor your opinions and wouldn’t dream of trying to change them because you make many great points. I’m of a mind that people should do the research, listen to both sides (because CAM ain’t gonna go away), and make their own decisions. I love a good debate, and that’s pretty much why I wrote my book. Anyway, your blog is great – keep up the good work.

  3. I’m here for the doggie porn! Nah, not really. I read you blog more consistently than I write my own and that is saying something!

  4. You just hit a point that I have made so many times, I don’t know where to begin. Though I tend to be pretty neutral on the moral basis of most religious points (including many of the recent social issues and their implications), I am pretty close with some pretty devoted members of my class. After what amounted to a solid month of bash the right wing religious guy classes (complete with a lecture from Planned Parenthood and a talk about the bigotry of questioning alternative lifestyles)a friend of mine snapped in a small group. In response to a previous lecture in which we were repeatedly told that homosexuality is morally acceptable because animals do it, he responded with the logical conclusion that this must justify us eating our young. He was summarily criticized after the fact for HIS lack of professionalism. This after they had done nothing but insult hom for a month. I am dreaming of the day when I can leave the University and all of the ideals of narrow brained open mindedness behind.

  5. You should see all of the citations I get for unprofessionalism. I was told earlier this week by our class policeman that I should apologize to a professor for comments that I had made publicly about him. This same teacher had been making sexually inappropriate comments to female students for years and has never been cited.

  6. You know Panda, the ironic thing is at my college today I ran across a student who said she was going to college in preparation of going to acupuncture school. Naturally, I thought of your last couple of posts on such glamorized quackery. I didn’t know whether to laugh or talk her out of it so I just went about my business. I figure people are so obsessed with open-minded “thought” nowadays that common sense doesn’t exist anyway.

  7. Don’t know what universities you attended but I’ve attended three different institutions and while I’ve seen varying degrees of acceptability for religious and moral beliefs, as far as I can see, there is no huge “anti-Western, anti-Judeo-Christian, and almost anti-intellectual” conspiracy.

    This ‘the liberal elites are out to get me’ reeks of paranoia, like this friend of my parents who thinks all white guys are racists against Chinese people and it’s a conspiracy to put the yellow man down.

  8. Yay, and I agree with you, Panda.

    You have been added to my list of favourites.

    The battle against unreason is, sadly, never-ending. But fight it I will. There is hope for the younger generation. One of my cousins, at the age of three years, dug out her toy doctor’s bag to operate on her teddy bear and, before the ‘surgery’ began, and without prompting, handed me the relevant pieces of blue nitrile (cribbed from the family doctor) and said “First, we put on our gloves.” I was so impressed I didn’t have the heart to tell her she’d omitted to scrub up. For the record, one of us operated; the other was anaesthetist – I deliberately did not reduce her to the role of scrub nurse, because I wanted to put it ‘in her face’ that girls could be doctors and need not always think of being nurses.

  9. Really, Nontradmed? I attend a major state university, and recently had occasion to visit the English department offices. The walls are almost literally _plastered_ with liberal propaganda, some of it quite laughable. I just had to ask the professor how a poster which said “The Patriot Act: They who can give up essential liberty to obtain a little temporary safety deserve neither liberty nor safety” was able to coexist on the bulletin board with the neighbouring pro gun control article.

  10. I eat the liberal elites for lunch. I said they were pervasive, I didn’t say I take them seriously.

  11. Lynn wrote “Oh, Panda, I’ve had so many ouch moments reading your post about CAM that I wrote my own thoughts on this controversial issue.”

    This is not a controversy- CAM is quackery. Only proponents would have you think it is otherwise. If you can’t understand; maybe it’s you: http://www.apa.org/journals/features/psp7761121.pdf

  12. That’s sort of my point and why my article on CAM is not controversial at all, at least it shouldn’t be among the physicians, residents, and medical students who form the bulk of my readers.

  13. In other words, if CAM can be explained rationally and consists of treatments based on hypothesis that can be tested, then it can be incorporated into medical practice. If it can’t and to defend it its adherents retreat to spirituality then it’s a religion and belongs in a church, not the clinic.

    And if your entire treatment modality depends on the placebo effect then maybe your patients aren’t really sick at all except in a spiritual sense in which case you need to go to divinity school or train in whatever flavor of spirtuality you favor.

    When you fall back on the placebo effect, you are saying that the substance of your treatment doesn’t matter at all compared to the style. Might as well hire actors who look and talk like doctors and give out sugar pills.

    There is such a thing as being too open-minded to the point where you are lose your powers of discrimination. Discrimination is the faculty we develop through education to either refine or discard prejudices. “Prejudice” is just another word for “hypothesis.”

  14. Coming to points that came to light in the previous thread, people brought up the fact that willow bark and various other substances were discovered by CAM. This provides a false luster of credibility to the witch doctor crowd. We’re not talking about ‘chew two leaves and call me in the morning.’ The willow bark in question was unrefined, uncontrolled, and it goes without saying, inconsistently dosed. Just because a quack’s preparation contains one thing that has a use, doesn’t mean it doesn’t also contain many more harmful things (Many ancient preparations incorporate animal feces for example). It takes a rational, evaluative stance to pull out what’s good and leave out what’s bad, which is where modern medicine enters the picture.

    All too often the worship of ‘natural’ things from the left is based in a very, very thin knowledge of history and nature. Dolphins are a classic example, they tend to be worshipped and idealized, but hard data shows that, if their behavior must be anthropomorphized, bullying and homosexual rape are probably more prevalant in their society than in ours.

    IMHO the failure of liberal ideology is it’s desire for easy solutions. Life would be happy and easy, if we only… banned guns, got back to nature, had universal health care, ate vegetarian, etc. I think the nature of life is such that if it becomes too easy that very ease will grow into a source of malaise, discontent, and eventually self destruction.

    Hmm, could I have wandered further afield there?

  15. thanks panda. i like coming here because it’s as if you are able to put my thoughts into a funnier readable format.

  16. Joe said:
    “This is not a controversy- CAM is quackery. Only proponents would have you think it is otherwise. If you can’t understand; maybe it’s you: http://www.apa.org/journals/features/psp7761121.pdf

    Thanks, Joe. I feel a lot better now. Because I have a couple differing opinions regarding integrative medicine, I’m an idiot. This sounds just like a bunch of liberals attacking someone because they don’t believe as they do.

  17. Lynn “Thanks, Joe. I feel a lot better now. Because I have a couple differing opinions regarding integrative medicine, I’m an idiot. This sounds just like a bunch of liberals attacking someone because they don’t believe as they do.”

    “Opinions” don’t matter, only facts count. It’s not that you don’t believe as we do, it’s that you don’t know what we know.

  18. Joe states, “Opinions” don’t matter, only facts count. It’s not that you don’t believe as we do, it’s that you don’t know what we know.”

    And it’s also a fact that you do not know what I know.

  19. Not to get repetitive, but facts are something you can prove. Honestly, all I want is proof. But if you don’t have it, there’s no point in discussing this topic. You have your faith, which is nice, but faith and the practice of medicine are two very different things. We owe it to our patients to use treatments that can be proven empirically. In the event of failure of conventional treatments, I can understand turning to alternative medicine, but only as a last resort. Sorry, simply not a believer, and your failure to recognize the difference between facts and your feelings doesn’t help.

  20. “You have your faith, which is nice, but faith and the practice of medicine are two very different things.”

    Oh, Joe, you couldn’t be more wrong. Faith goes where medicine can’t in many cases, and who are you to say otherwise? Do the initials of M.D. behind your name bequeath you as final authority on how people heal and when it’s permissible to seek alternative means? Just for the record, I’m not an advocate of foregoing medical treatment. I’m an advocate of practicing alternative modalities in conjunction with allopathic care.

    You say that I don’t know what you know because you’re a doc. Come on. Given that logic, this means that I should surrender my opinions to Hillary Clinton because she’s a politician and knows more about how to run our lives. I’d rather shoot myself. Hand me Ronald Regan, and I’ll walk away happy.

    It’s true that I don’t know scientifically what you know, but can you honestly say that the human spirit plays no part in healing and that you unequivocally know how to treat it? Dr. Mehmet Oz was extremely influential to me during the research phase of my writing, and you don’t get much more traditional and respected than he is. He discounts nothing when it comes to treating his patients, and I found his beliefs intriguing when doing my character development.

    Integrative medicine is being painted with too broad a brush, in my opinion. There are some highly questionable practices out there, and I agree that many can be ineffective and harmful. My main character rightly asks who’s to determine the good from the bad? It’s a valid question. And there are many good, solid hospitals that are answering those very questions. They’re studying and employing these integrative modalities, not because they think it’s hooey, but because there are enough positive results to warrant its inclusion. This can be seen with The Continuum Center for Health and Healing, which is a part of Beth Israel in NY. Andrew Weil M.D. is the founder of the Program in Integrative Medicine at the University of Arizona, and there’s The Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center. Something must be going on in order to have major facilities involved in these practices.

    I believe in natural selection just as much as I believe in a free economy. Where ideas no longer hold validity, they wither away. But if people are seeing enough results or success with an idea, it’s going to grow wings. Lastly, it’s okay that you’re not a believer. I just hope you’re not the kind of doc that scoffs in your patient’s face if they happen to mention that they’re practicing meditation or going to a reiki healer along with being treated by you. Remember, you ain’t God.

  21. I do know I’m not God, or a god, but I can prove that medical treatments work most of the time. Medicine is a scientific pursuit, not a religious one. For better or worse, with the scientific approach, we’ve lost the “Priest and Healer” role we once had (see “The Evolution of Modern Medicine” by William Osler, pretty accessible to the layperson). Science-based medicine is where we are today, it works (mostly), and we’re not going back.

    If patients want to seek religious paths in conjunction with therapy, that’s fine with me, but it’s not within my medical purview to prescribe that for them. I think you will agree that belief cannot be imposed, it must come from within. Up to them, not me. And what happens when God says no?

  22. I agree that it’s not your place to talk about religion, and of course in can’t be imposed. When I said faith, I meant the patient having faith in whatever alternative modality he/she prescribes to. Medicine is primarily a scientific pursuit but a good number of respected docs I researched with (including Mehmet Oz) believe that medicine has evolved to include the Mind/Body connection. The idea of a healthy mind = healthy body isn’t all coincidence and crap. It’s real. That you don’t believe it because you can’t measure it under a microscope doesn’t make it any the less real. Docs simply don’t know everything there is to know about how the human mind connects to and influences the body. To outright ignore other possibilities because they don’t meet traditional standards of testing runs contrary to the natural curiosity I see in most docs. Look to the patients. Talk to these hospitals that offer integrative programs.

    “Science-based medicine is where we are today, it works (mostly), and we’re not going back.”

    Not going back? Are you sure? If that’s so, then why are more hospitals including reiki teams on their surgical floors and cancer wards? I interviewed four such hospitals. It wasn’t because they felt backed into a corner with peer pressure. Their attitude vacillated between, “sure, what the hell, it can’t hurt,” to “we’re seeing a trend in patients requiring less pain meds. There may be something to this shit.”

    Tom, let me say that I appreciate your candor and willingness to spar. Unlike Joe, you haven’t called me an idiot, and I thank you. To do so is just rude. This is a controversial issue that’s heated up a lot of debate between docs and patients. And, despite what you may think, the paradigm is shifting.

  23. In the past, the roles of priest and healer were combined because, due to a lack of effective remedies, all the doctor/priest could do was to hope/pray for the patient to heal him/herself, or offer consolation. While there remains a need for consolation in terminal care, I do not think it is what the average patient seeks when they come to the office. They want to be cured, not consoled. Thus the separation we see today, between the scientific and religious.

    I would say only that the exceptions that you mention are just that, exceptions. The fact of that matter is that alternative methods do not work for the vast majority of people who try them, and to point people to alternative medicine with that knowledge is, in my mind, wrong. For believers, there may well be a powerful modality at work, but the vast majority of patients do not have that faith basis. We work under the confines of science, seeking for the universal, not the exceptional/miraculous. Until the world is full of the exceptional, I don’t see us abondoning what we have.

  24. Lynn said, “Something must be going on in order to have major facilities involved in these practices.”

    I think the “something” is money. It’s the same something that drove the establishment of all the varied types of hospitals before any of them could do much of anything. Allopathic medicine developed past that point, but it doesn’t change the fact that people will pay for anything they think works.

    It’s a vicious cycle. Medically uneducated patients believe something works, which causes it to have an effect (the placebo effect) and causes them to pay money for it. Reputable hospitals want the money and want the placebo effect. Patients believe that reputable hospitals wouldn’t offer something that wasn’t worthwhile, so their belief in the efficacy increases.

    CAM is still crap.

  25. I would have said this to Lynn on her blog, but it’s jacked up and requires a log on that I don’t have. I hope Panda will let me post it here, because it bears on the argument. It’s in response to a post by Lynn and a comment by Randall that doctors refuse to experience and instead shut their eyes to things they can’t understand. I’m only finishing up my MS1 year, so any mischaracterization of research is due to my relative lack of knowledge.

    “Experience is composed of what? Generally some sort of event. If you have a lot of experience, you have a lot of events. Normally you don’t record them, but you remember them and have a general idea of the balance.

    Medical research systematically seeks out many of these events. It doesn’t trust memory, but carefully documents the events. Then it examines them. Practitioners of Western medicine don’t refuse to “experience”, we insist that all experiences are noted. If a patient drifts away because Reiki isn’t helping them, do you notice? Do you log it as a failure of your treatment modality? Are you refusing to “experience” this failure? Do you see my point?

    Stopping your meds because you felt better is a frightening indictment of CAM. I’m so happy you didn’t have a negative outcome, Lynn. May I ask what you were being medicated for?”

  26. “Stopping your meds because you felt better is a frightening indictment of CAM. I’m so happy you didn’t have a negative outcome, Lynn. May I ask what you were being medicated for?”

    Hi Moose, I couldn’t agree more, and I would never advocate stopping meds to anyone. Ever. Nor would I ever recommend that people stop going to their docs. It’s utter lunacy.

    In my case, it became a matter that my body suddenly (and I do mean suddenly) could no longer tolerate my meds. I was taking Ritalin for ADD and ogen for HRT (complete hysterectomy at age 36).

    Mind you, I’d been on both meds for ten years with zero problems. I was the poster girl for both meds. No side effects, excellent results. There was no need to discontinue taking them, nor was I looking to. With the Reiki treatments, my body repelled them both. I went to my docs and they recommended lower doses. This kept going on until they finally told me to quit taking them since the doses were practically down to nothing. I did. They retested me and uttered “BTFOOM.”

    I was only doing the Reiki bit as research for my book. I thought it was a bunch of crap. Not only am I not taking anything, but all symptoms of my ADD disappeared as well. This was pretty damned alarming, and I knew I had to look into this further. So when you say that “CAM is still crap,” all I can say is, “No it’s not.”

  27. Reiki? Come on, you got to get out more, lol.

    “Shamanic experiences are quite natural, only our culture has become so removed from them that even our scientific observers do not possess the
    appropriate concepts or experience to understand them.” – Ian Prattis

  28. Reiki is essentially the “laying on of hands” to heal someone. The practitioner shoots healing energy into the recipient through his hands, possibly also working to rebalance the recipient’s own internal energy in the process. Needless to say, it hasn’t been well received by the general scientific community, and studies generally show the same efficacy as a placebo.

  29. “Beating your wife is quite natural, only our culture has become so opposed to it that not even our alcoholics are allowed to gain the appropriate experience to properly appreciate it.”

    The quote doesn’t say anything. It’s by another Shamanic handwaver. What do you expect anyone that doesn’t believe in that crap to draw from that quote?

  30. Panda– Congrats on the hits! You communicate your points well. You need to read Discover Magazine and think about submitting to their doctor page– I forgot what they call it, but your writing lends itself to their readership (academics and non-academics.)

  31. Don’t worry, Panda. Some of us shun the supernatural aspects of the Eastern religions as much as the Judeo-Christian traditions. I do have to wonder though whether your disposition toward cynicism and reason would’ve resulted in you becoming a Humanist under different circumstances.

  32. I do not shun Christianity and I am not a cynic when it comes to Christ through whom all things are possible.

    But medicine is medicine and religion is religion and we will give to Caeser what is Caeser’s and to God what is God’s.

    As for Reiki, if I were a resident at a hospital that paid for that I would be grade-A pissed, especially as one of the reasons hospitals give for not paying the house staff a decent wage is that they are strapped for cash. It would kind of sting a little to be working for nine bucks an hour, losing sleep and working hard, only to see the hospital hire a magician to shoot spiritual fire out of his ass.

  33. Without meaning to offend you Panda (although inevitably it probably will), surely somewhere in the back of your head your crocodile brain must be yelling at the absurdity of believing that ‘anything’ is possible through Christ, while at the same time rejecting the so-called merits of Qi, reverence toward bovine creatures, and the 57 varieties of virgins awaiting us in heaven.

  34. I reject the use of mysticism in medicine and I no more would refer a patient to acupuncturist than I would to a television faith healer. I don’t know how I can be more clear than that.

    And I will not debate religion on this blog and I’m going to deleted comments on religion which are not relevant.

  35. “The quote doesn’t say anything. It’s by another Shamanic handwaver. What do you expect anyone that doesn’t believe in that crap to draw from that quote?”

    Moose what you would draw from the quote is that there is cultural bias. Most Western researchers probably take For example, Chinese studies with a grain of salt due to a cultural bias and history. However, we must do the same with the studies you base your “beliefs” in. Now, if you could do a study where everyone was blinded, patients, physicians, nurses, etc., then you might have something free of of the distortions of human consciousness and subjectivity. The shamanic “stuff” I practice has psychological and anthropological studies behind it. I also take that with a grain of salt. I know that some anthropologists look down on their buddies who “go native.” But I personally would like to read a book from a guy who put on a loincloth and lived with a tribe versus one who sat outside the longhouse and took videos and described what he saw from his biased western cultural viewpoint. See my point? I’m all for people doing research as it gives someone a job. But, at this point in my life, I get some satisfaction from a patient who feels “subjectively” better after nothing else has worked for them. With a soul retrieval, one can in one session, find the original wound, compared to years in therapy. Which would you rather pay for? When I did a journey (keep in mind this is a mythic and imaginary journey)with my very first “client” …a fellow student and a person I had just met seconds before, I saw in his Chamber of Wounds a landing strip with alien spacecraft landing. Now, you’re thinking this is really crazy stuff(as I did). However after working with this 50-60 year old guy some more in a group he broke down and said he finally realized that he has been “alienated” all his life. He was also a pilot who had just given up his planes due to their high cost.

    Now go to my very last client yesterday. This was a lady from India and I saw colors everywhere during my journey, including a colorful scarf reaching to the sky (she admitted to be currently painting a rainbow); I saw a girl who had written a contract saying, “I’m too little” (she said her father had told her she was a nobody and beat her down emotionally). I also saw a mouse for her power animal(she said she was called the Indian word for “mouse” when she was in school). And her name in India means “one who feels people’s lives with color.”

    So far, 100% for “reaching down inside” in one session with these imaginary journeys and helping people with their problems. Is there something wrong with that or should I wait on more culturally biased studies to be sure my clients are “objectively” better?

  36. All right, Panda – fair’s fair – I was a little off-topic with the jabbing. But let’s be honest here…religion is not religion and medicine is not medicine. If it were, we would haven’t the Religious Right dictating America’s stem cell research policy.

  37. Panda said:
    “As for Reiki, if I were a resident at a hospital that paid for that I would be grade-A pissed…”

    Panda, the Reiki programs in virtually all of the hospitals are voluntary – meaning that special Reiki healers are trained in how to work in a hospital setting. They become certified by the hospital and no one gets paid. You’ll have to look elsewhere for the reasons behine your crap wages – something in which I sympathize with you.

    In the case of The Continuum Center for Health and Healing in NY, this is an integrative/allopathic care facility. The patient has a 45 minute appt. with their doc for a thorough exam, diagnosis and discussion about what forms of treatment (both alternative and allopathic) the patient is comfortable with.

    You mentioned how you’d never refer a patient to an acupuncturist – never say never. I interviewed a most interesting doc who sat in the same chair you do. But he’d run out of options with his young patient and sent him to an acupuncturist. The kid went on to thrive and reduce nearly all his meds. When I get back home (out of town right now) I’m going to talk about that case on my blog.

    I know that your opinions on integrative medicine are unlikely to change at this point in your career, and I’m good with that. You have a lot of bigger fish to fry right now. But I do want you to know that there are thousands of docs and other medical personnel whose opinions differ greatly from yours, and because of this, the debate isn’t going to go away. All I’m trying to do is bring a bit of education to the playground because knowledge is power. In a world where medical breakthroughs are happening all the time, it’s unwise to flat out dismiss a modality due to a lack of understanding (or desire) even when there’s evidence to the contrary.

    You know what’s funniest of all? I had a woman who’s very big in the integrative care community decline to review my book on the merits that she’s never encountered docs who were opposed to using alternatives. Talk about someone whose head is in the sand. All I could do is laugh.

  38. I take a lot of vitamins and supplements just because I feel increasingly less than optimum when I don’t. But I also know I’m a suggestible person (I’m old and have yet to meet a human being who isn’t) and it all could be the ‘placebo effect’. As long as I don’t harm myself then I say “Viva the placebo effect”. Though I usually call it the ‘voodoo effect’.

    What I abhor are all the new agey gurus, the ‘tinctures’ and the waving of hands. They simply bore me. Along with seers and numerologists and spirit guides, etc.

    I do appreciate humans’ need to worship and acknowledge their spirit natures. However, I believe in the one true God, all others (including CAM) are wimpy and superficial at best and fully or potentially murderous at worst.

    When I see a doctor I hope he is grounded and growing more so in the sciences as well as compassionate toward his patients. What god he worships (everyone has one) or whether he worships God is not any part of what I hope from him.

  39. Stem cell research, like abortion, has a moral dimension. Therefore it is only right that Christian physicians consider it.

    And you are not taking “jabs” at me for the obvious reason that to be made fun of for believing in Christ is kind of sort of a compliment.

    Lynn, Somebody has to train Reiki “healers” and as sure as God made little green apples, money is changing hands somewhere. The “healers” may “work” for free but there is a money trail to be followed.

    I am also distressed that it took you a while to discover that Reiki is crap. I had never heard of Reiki but as soon as “healing energy” was mentioned my suspicion that it was bunk was instantly verified. You don’t need to know anything else about it and could sit in Reiki seminars or training sessions for months and it would still be bunk. In this case, recognizing something like this is beyond skepticism. I mean, I’m skeptical about a lot of the things that we do in the practice of medicine but at least these things are open to rational experimentation if somebody bothered to take the time.

    But “healing energy” flowing from the fingertips? That’s a no-brainer.

    I repeat, I do not and will never refer somebody to an acupuncturist any more than I would send them to an exorcist. My patient’s spiritual life is none of my business and as I don’t prosyletize for my own faith, why should I do it for somebody else’s. They need to make their own converts.

  40. You forgot to mention that you only consider studies done in the United States as valid.

    How do you view hyperbaric oxygen therapy? Why do most doctors consider this CAM even though it is FDA indicated for sixteen conditions?

    Because the curriculum is so goddamn awash with Pharma propaganda, that’s why. I did not sign up to be a cheerleading drug piddler for Christ’s sake.

    Let me use my brain, because most Docs sure don’t.

  41. You’re right about stem cell research having a moral component to it. It’s just unfortunate that so much of the opposition is based on blind dogma without a hint of pragmatism. Aborting a fetus is morally reprehensible to you? Fine. But gimme a break when it comes to extracting pluripotent stem cells from a ball of cells about size of the period at the end of this sentence (especially if that ball of cells was a ‘leftover’ embryo from in vitro fertilization). I’m betting that all of those who are shouting ‘but that blastocyst could one day be life!’ are the same people who don’t have type I diabetes or some sort of serious neuropathy.

    People might say that they base a majority of their morality on some kind of scripture, but let’s be honest here. Does a religious person not go around killing, raping, and stealing from people just because it says so in a book, or is it possibly because a few hundred thousand years of human evolution has programmed his brain to act with compassion and reciprocity to others because it furthers the species? I think I’d like to believe that man can be moral, ethical being without having to resort to the supernatural.

    Sorry if I mislead, but I didn’t really mean to say ‘jabbing’ in any form related to ‘making fun’ of you. There’s a difference between saying ‘hey stupid christian durrrr lol’ and questioning why you only selectively employ reason and rationality.

    Also, yo mamma, where are these doctors who consider hyperbaric O2 to be CAM?

  42. Yo’mamma, the point is that we can objectively determine if the pharmaceutical rep is bullshitting us. I am in a specialty where I don’t really prescribe a lot of medications so we are not courted quite like the internists and the family practioners. You need to have a little faith that the rest of us are smart too and that you are not the only one who is a skeptical.

    But believing that a cardizem drip will slow a patient’s heart rate if they are in atrial fibrillation is not the same as believing in Rieki, acupuncture, homeopathy, or any other treatment modality that require a whole other world-view. If it is brought to my attention that cardizem is useless and it is actually an additive in the IV bag doing the trick, I’ll curse, laugh, slap my head like a motard, and stop useing cardizem. I’m not in love with it, any drug, or any therapy at all and I have nothing invested in continuing to do things the wrong way except the usual inertia of mankind.

    But like I said, nobody who believes in acupuncture will ever give it up, no matter what.

  43. Randall, reason, I repeat, is not a cultural bias. 2+2=4 in the rainforest, the tundra, or the great Gobi desert.

  44. I am a political liberal, yet I agree with virtually everything you have written here. CAM is largely bullshit, and no different than snake handling if it does not have evidence behind it (which almost none of it does).

    The one issue on which I quibble with you is the idea that liberal, pro-choice professors are supporting the Taliban – I think you will find if you read back issues of The Nation or other liberal magazines that political liberals were sounding the alarm about the Taliban long before the mainstream media, and long before 9/11. Feminists especially were writing articles warning about what horrific bastards they were. But I do take the point that higher ed is too faddish – the views of professors and curriculum heads are too easily melded into the classroom, whether those authority figures are liberals in the English department or conservatives in the Economics department.

    Otherwise, good article. I work as a tech at a hospital, and it is completely shocking how many nurses, techs, and other staff are into CAM stuff, Kevin Trudeau books, and other obviously pseudoscientific claptrap. It is truly appalling.

    One more thing: “it’s,” with an apostrophe, means “it is.” It’s an easy typo to make, yet makes your writing a bit confusing at times.

  45. Oh hell, Sarah, do you think I don’t know the difference between “it’s” and its.” I appreciate the corrections but, as you point out, it’s an easy mistake to make, compounded by the fact that I write most of my posts late at night when I should be sleeping.

  46. No, I certainly don’t think that you don’t know the difference; you are an excellent writer, as others have pointed out. I shouldn’t have said anything – I just tend to be a bit of a punctuation snob 🙂

    Good luck getting more sleep.

  47. I do think a little consideration for what people are looking for is warranted, because it opens our minds, not necessarily to bullshit either…touch and laughter are great CAM. I give patients 1 minute backrubs, if I have time and think they need it, and I have developed the talent for getting them to laugh, even the kids and babies. Hugs are rarely indicated but powerful.

    Panda bear, before you sclerose entirely into a totally anti-CAM mindset, find one of those
    Korean massage parlors and spend four hours getting a galomphing (my term, I think, although I may have heard it someplace-winnie the pooh?) treatment and you might have more understanding about the comfort attraction of CAM, which totally allopathic people, well, just don’t get until they’ve been properly galomphed.

    That said, I’m not sure the Koreans galomph the males. It might be that such treatments don’t exist for the guys, which would be unfortunate in this man-bashing world. I would hate to think that my husband and 2 sons would never be able to experience galomphing.

    The one time I went to such a place I recall a team of females with wet t-shirts in a steaming splashing tile room with 3 or 4 pools of differing temperatures. These ladies led me around, getting more and more noodled, to this table for soaping, that table for scrubbing, the other table for lotioning and lathering and rubbing, intermittently pouring buckets of water over me like an elephant in the dry season. Then came the dips, then the hot sand lolling-around room…removal of all cares, like, for years. In fact, I think I’m due..

    Check it out.

  48. Gaye, have you gone insane? For the record, I am not against laughter, hugs, massages, or Korean chicks in wet t-shirts but good Lord, couldn’t you have just become a circus clown who who does little exotic dancing on the side and saved yourself the time and expense of medical school?

    I don’t quite understand what your post has to do with homeopathy or acupuncture but thanks for reading my blog.

  49. OK, OK, I don’t bother with connecting the dots much, sorry. My point is just that the masses of patients want sensual, bodily, aesthetic, and spiritual comfort, and they are finding a profession that claims to take care of their medical problems while providing same comforts…. Much of modern medical practice doesn’t recognize that.

    Just having ragged-out interns running hospitals scares the shit out of many, including me. OK, I think I killed a patient once, not due to error, they just died 2 seconds after administration of an IV drug the attending advised me to tell the nurse to give him (lidocaine, hey, not on the ACLS protocols as much as it used to be..). Just imagine how fucked up I would be if I’d made an error, while on my 12th admission of the night and on my last neuron?

    So take for instance my friend Hao Sen from Sichuan province. Has opened an acupuncture clinic. You walk in the place, it feels good.
    Old Portland house, each room with plants and
    lavender sheets. Great apothecary room, looks like turn-of-the century Hong Kong. He horses around in there with his needles, and patient’s innate tendencies to get better and worse with their chronic conditions keep him in business. Oh God I hope he doesn’t read this post.

    His wife, the world’s most KICK-ASS cook, gives cooking classes upstairs. They will live to 105 on that diet.

    TAKE NOTE ye charmed medicine-lovers. A good color scheme, artwork, plants, a massage-chair
    and serious bedside manner will attract patients and keep them safe from acupuncture, which, as my beloved mentor, the Jewish surgeon, said, is just another good way to get stuck by your doctor.

  50. Whoa. Sensual comfort is not part of my duties as a physician. Maybe a certain subset of patients expect to be pampered but we’re not running a day-spa.

    And you’re as much as saying that your acupuncturist isn’t really doing anything for his patients but providing entertainment. That’s sort of the difference between CAM and real medicine. Real medicine, other than good bedside manner, doesn’t have much entertainment value. Regretable, to be sure, but I like to think that most of our patients seek us out for our medical expertise, not our style (although to be sure a good doctor developes his own style).

  51. OK, brass tacks here…people feel comforted by an inviting environment and like a direct, friendly doctor who also acts like they give a shit about them. Just put the two things together- a calming environment and a good physician and maybe the CAM people will start trickling back. Wouldn’t that be a good thing?
    Or is that too much of a compromise with glaring reality?

    Sensual…I think I was talking about the colored sheets and the African violets, not about anything sexual or sensuous. I forgive you, I had to ask my husband which was which.
    “Daddy, what’s the difference between sensual and sensuous? I think I might have said something creepy to the ED Dr, you know, he has his weirdness scale a little amplified, spends a lot of time with no windows and a large freakshow happening around him all day…..”

  52. By the way, if you are convinced that modern medicine is the only way to go, lets see you talk to my wife about the cancer treatments that didn’t work, the anti-nausea medication that didn’t work, the MRI that didn’t find what was there, and defend the arrogance of a doctor saying “it must be functional” 3 weeks before she was diagnosed with 3rd stage breast cancer.

    You might be somewhat chastened. Just like the dozens of MDs who, when THEY are diagnosed with something, notice that there is something wrong with the way traditional medicine deals with patients. If you look at cancer survival rates, (not 5-year, but true mortality), or you look into bypass surgery and why we do it, or stents, or any number of questionable treatments, you start to notice that maybe you don’t have the whole story. THAT is why people look to woo.
    And anyone who argues that you can’t be pro-gun and anti-Patriot act is an idiot. Period. Go back to the 50’s, they miss you.

    (Where on Earth did I ever say that?-PB) 

  53. So what you’re saying is that since modern medicine isn’t perfect we may as well believe in magic beans, homeopathy, and the works.

    Come on now. That makes no sense. “The doctors misdiagnosed me so next time I’m trying the psychic hotline.”

    By the way, maybe you don’t know this but I’m a resident.  I mention it because our whole job description is to be chastened on a regular basis so if you think that your doctor has been bred to be arrogant you are sadly and deeply mistaken.  This is another example of the ignorance of the public about what it takes to become a physician and what we have to go through for the privilege of listening to your complaints.

  54. Now listen Panda Bear,

    John and I have telepathically concluded you have a blind spot.

    The institutions of modern medicine have simply got to repair their image, and guess what, it would not be hard. ESPECIALLY if you want doctors to keep getting paid what they deserve, AND for the burgeoning of CAM to calm down.

    1)Introduce colored walls, fabrics, plants and sculptures to facilities without breaking the bank.

    2)Insert year-long bedside manner training courses to medschool curricula; have asshole attendings come demonstrate how not to act. (just kidding)

    3)teach in medical school, on day 1: apologize, apologize, apologize. Learn how to say “I/we fucked up, and we’re sorry.” Let students look at histories of cases gone wildly wrong due to idiocy, and how people really decided to sue because nonone admitted fault, even when it obviously happened.

    4)Make doctors who are incompetent go away to do Paps, DOT and IME physicals. Well, maybe not Paps, that might not be safe, although we would dearly love to punish them with such a duty..

    5)Mandate all residency programs adopt block nights. Kiss goodbye to the 1/3 or 1/4 call schedule, which is a brutal, senseless idea akin to child labor, sex slavery, etc

    The internet, that delicious and fecund whore, may actually engender the critical weight to force introduction of block nights to the call schedule. That alone would have HUGELY positive effects on image, morale, competency, etc Not that the people making the decisions have enough vision to understand that.

    So, someone just needs to start a website that collects anonymous stories from residents. Just the press from that will get the ivory tower honchos, and their associated admin dogs, to start rethinking things. The Libby Zion case would be a teeny, teeny drop in the ocean compared to what such a tide of stories might do.

    Panda? Forget the MBA. Compile and publish those stories, it’s time.

    P.S. Just in case I’m wildly off my rocker, did widespread adoption of block nights happen, and maybe I’m unaware of such good tidings? I don’t keep much in touch with training hospitals….when I was a resident, there were like, 10 hospitals in the country with the humanity to offer block nights.

  55. Colored wall fabrics are disgusting, I agree.
    I was referring to colored walls, like, with paint, sorry if it wasn’t clear. I believe colored paint costs no more than white paint.

    The fabrics refer to curtains and sheets. I believe they still have those in hospitals, even pandaverse ones.

    OK, fuck color.

    How about block nights? Or would that besmirch our national reputation for working hard?

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