Hard News: Miracles just rate better, okay?
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@Sacha
Tell it to an engineer. Good sanitation and water supply have saved more lives than doctors ever have.
And who was it who taught the governments that good sanitation was necessary so they employed the engineers? Try John Snow, the man credited with founding epidemiology after he deployed statistics to trace the source of a cholera outbreak in London in 1854 and proved it by removing the handle of the contaminated communal pump thus causing the end of the outbreak.
Or Edward Jenner and his smallpox vaccination that lead to the whole modern field of vaccination?
The discovery of the sodium-glucose co-transporter in the gut and the addition of glucose to Oral Rehydration Therapy has been credited with saving more lives in the 3rd World than antibiotics. You can fight off Cholera if you can avoid dying of dehydration or hyponatria (low sodium). ORT does not need refrigeration, only boiled water.
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Just hope your need for a 'tonic' isn't that undiagnosed tumour weighing you down, eh?
Hey everyone, your shipment of buzzkill has arrived!
Honestly Peter, you probably don't need to dangle the sword of cancerous irreversibly injured Damocles over everyone's heads quite so much. No one here has even made mention of avoiding their GP. (Apart from me. But I don't deal with woo medicine either: I'm always trying to put off seeing people like doctors, dentists and hairdressers. I am a wimp.)
John Snow, the man credited with founding epidemiology after he deployed statistics to trace the source of a cholera outbreak in London in 1854
ETA: OMG. What was the name of that book I read recently about that? The something City? Anyway, the first chapter was *hauntingly* horrible. The jobs people had in Victorian London! 'Oh hi, I make a living by wading through sewers collecting rags and bones to sell. Every now and then there's a gas explosion in the sewer, and I could die in a puddle of shit.'
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Have just watched Media 7 prog on the "Miracle Cure" the whole reason for these 4 pages of posts. A good coverage. Addressed the Close Up and 60 minutes coverage and it's total lack of balance. The lack of response from reporters and producers - telling to say the least. Russell asked some good questions. The two panellists told it like it is.
What I couldn't get out of my head the whole time was the issue of NIMBY. Depersonalisation. It happens to other people.
Given what has passed these pages over the last few days it is obvious that once any condition suddenly impacts us in the guts (personal or close) all our well meaning tut tuts disappear out the window.
So I can't help thinking that it has to be some kind of innate response from way back. Heavily evolved and extremely difficult to let go - let alone ignore - that would allow the "tut tuts" to be effective within ourselves.
Its is not a good thing bad thing. It is there. Locked up ready to pounce when something hits you.
I suggest that it being evolved means that there will be variation, difference, extremes orthe non existence of whatever it is throughout the population.
And again, I am drawn to the thought that until we educate ourselves, educate the next generations of these facts of life we will be behoven to this programmed response for ever.
PS: And I hadn't watched it before I made the Book Review Request above BTW.
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@Ben Wilson
The problem with your situation is that you do not expect reality, you want a miracle.
I would certainly like a miracle, but I don't expect one. I also don't expect not to get one, unlike you. There is no reason to believe that it can't happen, any more than the reason to believe it can. That's what's irrational about your situation, sir.
There is no such thing as a side effect free effective drug, biology and chemistry just don't work that way.
I don't know what you mean by this sweeping generalization about some enormously large fields of human inquiry.
I am sorry that you are in the situation you are in, you have no good choices, only ones where you have to balance risk vs benefit. Welcome to real life. Forget about the possibility of a miracle cure. But be glad that you live in a time where there is a viable therapy
I'm sorry that you can't accept that the limits of human knowledge are ever expanding and that you don't actually know all of them. You don't know my situation, you don't know the future, you don't know everything that is possible, you don't have the only drop on real life. Not even the doctors I deal with (who are specialists in this field) have such a ridiculously pessimistic view of my chances, or of the possibility of alternatives working - they just don't want to put their names against it, for a number of reasons.
I don't expect ever to be 'cured'. But it is entirely possible that new drugs, or an untried combination of them, could provide me with a massive improvement in the quality of my life. This has already happened several times. It could continue to happen. It's also entirely possible that other therapies will help. You don't know that this is not the case. Furthermore, even conventional science could come up with new drugs - again this has happened several times in my life. Topical immunosuppressants didn't exist when I was a child, certainly not in commercially available form, and the price of them may continue to drop drastically making them more viable. Maybe something else will come up - who bloody knows, man. You sure don't and with your attitude you will never find out either.
There is, for example, the hugely untapped (for me) mental side of eczema, since it is mostly exacerbated and spread by scratching. A means of controlling that alone would improve my situation a lot. This could come from drugs that suppressed the urge to itch, or other therapies that have the same effect. Maybe it's stress related. Maybe it's allergens that weren't tested. Certainly I suffered a lot less from eczema when I lived in Australia, possibly it's Auckland related (apparently it's a city with extra high numbers of people in my situation).
Then there's the possibility that dietary factors are contributors. I have not yet tried to work my way systematically through every food group because it is a massive undertaking that will put pressure on everyone around me.
Maybe it's all of these things at once, or some subset of them. The number of subsets of a group of factors is exponential on the number of factors, so expecting a massive study to be done on people who have everything about them that is exactly the same as me is not feasible.
I'm not going to give up hope just because your creed is so limited. Sorry to burst your bubble there. I'm the one in charge of my life, I'm the one making these choices and I'm the one suffering the consequences of them. You're just some guy who isn't helping, and doesn't want anyone else to try.
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@HilaryStace
Look at something like manuka honey and its antiseptic properties - where did that idea come from? Now been proven through randomised control trials. A remedy from one tradition tested and becomes part of another.
As Lucy Stewart says, honey therapy is ancient. Remember that there were no honey bees in NZ prior to European settlement, so it cannot be a traditional Maori therapy. Manuka honey is simply more effective than other honeys. All recipes for making mead stress that you must boil the honey solution for the stated time to kill off the factors that inhibit microbiological growth, or your yeast will not grow. I wouldn't care to try making mead from manuka honey (even if I could afford to do so).
BTW manuka honey has only been demonstrated effective as a topical antibacterial. There is no evidence that the active ingredient (whatever it/they may be) survives the stomach or small intestine. So all those people paying well over the odds for manuka honey here in the UK thinking it must be good for them are wasting their money. Don't worry though, in the interests of supporting NZ's export industries I keep my mouth shut on that one. Slap it on your ulcer, even use it on a (proven) Strep throat (antibiotic resistance being what it is). But don't eat it expecting it to cure anything else.
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It seems I need to clarify my example of digging the garden to cure my bad back. On the first day I did a little bit, being careful to keep my back straight and not use it like a crane. I stopped when I felt it twinge and took 2 ibuprofen before bed. On day 2 I repeated except I managed some more. On day 3 I felt great (I'm a quick healer) and got myself into a good rhythm with the necessary good posture and finished it. I followed this up in following weeks by taking the point and strapping on my running shoes which includes core body strengthening as part of my warmup routine. I have not looked back, but I still dare not try reading in bed. I cannot feel my back if I keep active, keep good posture and don't read in bed. I live in fear of not being able to keep active enough, I do not consider myself cured of a back bad, I just have it well controlled.
Digging the garden was simply the structured activity that worked for me. I introduced it as an example of activity being effective. Feel free to introduce your own version (raising a glass is insufficient though) but be careful out there and don't try and be a hero.
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Just hope your need for a 'tonic' isn't that undiagnosed tumour weighing you down, eh?
Get back to me when western medicine has a clue about arthritis and most other auto-immune or chronic conditions, will you good chap.
Your love of good whisky at least gives me hope you are capable of appreciating beauty in life beyond the scientifically provable.
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Though I'm not holding my breath for the medical industry to grow some humility about its limits.
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Get back to me when western medicine has a clue about arthritis and most other auto-immune or chronic conditions, will you good chap.
You are taking the piss, right? Because if it weren't for western medicine, the word `auto-immune' would be utterly meaningless, let alone being able to say that arthritis is related to it.
(Also, of course, merely because western medicine doesn't have all the answers doesn't mean that it isn't far and away the best bet. Testing things against reality is really really quite useful.)
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Keir, I am not against the scientific method but when the best answer Western medicine has had for over half my life is to try to suppress my immune system, I think it's pretty clear who's taking the piss - the quacks who call themselves rheumatologists and the jumped up little demi-gods who prop them up.
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Again, immune system is an idea that only exists within a western medical framework; hell, the idea of medicines that reliably work only really exists within a very modern western medical framework.
And if you had, say, gout, I doubt you'd call rheumatology quackery.
(Also, it is possible that the best answer western medicine has is both pretty shit and still better that anything else on offer; there's a proverb from I think either the LSB or the LSE that says `often there is no solution', and it is basically right. And of course western science gets stuff wrong, but it does so far less and for a far shorter time than any other way of finding out
stuff about the natural world; that's why western medicine has the germ theory of disease and antibiotics and vitamins and traditional chinese medicine has funky ideas about tigers.) -
I am not against the scientific method but when the best answer Western medicine has had for over half my life is to try to suppress my immune system, I think it's pretty clear who's taking the piss
Arthritis is a an autoimmune disease. This is a relatively recent appreciation by medical science. You won't get it by cracking your knuckles or by not running on the roads though the use it or lose mantra has some truth as it seems onset is earlier in the sedentary.
Since we are at the present time unable to rid your body of the immune cells that are attacking your joints the best therapy then becomes overall immune suppressant. I assume you must have it bad since this is only offered to the most severe cases for obvious reasons of risk/benefit. You have my sympathy as I have suffered with my joints but continually test negative for any Rheumato-Arthritic conditions (I just have loose joints). I know what deep joint pain feels like.
Be glad that we have found the cause which means a proper cure is now possible even if you have suffer a partial one in the interim. To do it properly would probably require nuking all your bone marrow then keeping you in isolation for weeks while circulating cells die off naturally and are not replace and letting your joint inflammation subside before repopulating. You would still need to take immunosuppressants afterwards though unless the tissue match was absolutely exact (got an identical twin stashed away?).
Be careful what you wish for iow.
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@peter
@Russell
The point of the Cochrane findings is not that Chiro and Osteo were as effective as standard medical treatments. It was that even standard medical treatments are not significantly better than either placebo or doing nothing.[...]
You have been wasting your money, suck it up.
Peter, I think this is harsh -- it would be silly to deny that Russell derives real benefit from visiting his osteo. However, the process by which one becomes a regular osteo (or whatever) patient is massively self-selecting -- the repeat business the osteo sees will be from the people who "got lucky" the first time, and even if it is solely a placebo, the effect is self-selecting and self-reinforcing. (Now that I think about it, problem gamblers often "start" as someone who gets very lucky the first time they gamble; I am not sure you can be a "problem osteo" patient, but Russell did get very lucky the first time he put ten quid on a horse called Osteo, and who can blame him for trying -- but no-one is going to round up a hundred Jimmies to repeat the experiment - - and Russell I hope you don't mind me making light of what must have been a very trying time in your life over this.)
The real question is whether you would routinely advise a person suffering from condition X to visit an osteo, and there the evidence is that they will get no more benefit than they would from any other "cure". But given that osteopathic treatment has already "worked" for Russell in the past, my guess is that the odds are much better that it will continue to "work" for him in the future.
It reminds me of a story my Dad likes to tell, about a chap in France who used to make his living traveling round village fairs and offering to predict the sex of a pregnant woman's baby (by what method I do not know, but clearly without the use of modern techniques like amnio or sonography). If he got it wrong he promised to refund the cost of the "consultation" on his next swing through the village -- he made a tidy living, even though he kept his promises about the refunds.
Your osteo likely makes his money in much the same way -- even if all he offers is a placebo, he will still see repeat business from the people who actually experienced the placebo effect. And since the osteo sees a stream of satisfied customers leaving his office (as well as some first-timers who never return), he may well be equally convinced of the efficacy of his treatment.
But that said, if it works for you Russell I would continue to make use of it :-)
On the other hand, the chiropractic profession does seem crooked to me, even if individual chiropractors are honest and upstanding members of the community. As I noted above they are very careful to adopt the outward trimmings of scientific medicine (the white coat, the title "Dr", and lots of latinate mumbo-jumbo) but refuse to accept its conclusions.
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@BenWilson
There is, for example, the hugely untapped (for me) mental side of eczema, since it is mostly exacerbated and spread by scratching. A means of controlling that alone would improve my situation a lot.
I am not wanting to offer advice, but have you tried hypnotherapy -- there is nothing intrinsically woo-woo about it (no crapola about meridians or energy fields or the rest of it -- I won't get kicked out of the scientists' club for suggesting it, although I suspect some practitioners do pile on the baloney a bit), and for some people it is efficacious.
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@Richard
What you say is true, providing it proves safe for Russell on an ongoing basis. As I have said before, if what is being offered is a placebo (and the evidence says Osteo is), then the risk/benefit equation is very different since benefit is in essence 0 then any risk gets magnified even if it is rare. Which is how rare bad reactions to vaccines against nasty diseases are accepted. As we begin to vaccines against less and less nasty diseases and of lifestyle and late onset in particular those rare instances will loom larger and larger in the risk/benefit equation.
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@sacha
Though I'm not holding my breath for the medical industry to grow some humility about its limits.
In the last 150 years, scientific medicine (including public health improvements, which you initially blew off as "engineering") has added something like forty years to average human lifespan.
In the same time, let us generously assume that homeopathy, acupuncture, chiropractic, Bach flowers, reiki and heaven knows what else have added a day to that lifespan (has anyone -- even a chiropractor -- even bothered to TRY to calculate this?? Let me guess why not?)
And you think it is the medical industry that should be humble about its limits?
I don't want to be a needless cheerleader here, big pharma and the medical industry has a number of deep structural problems, but the amount of human misery that has been alleviated by scientific medicine is breath-taking.
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@peter
@Richard
What you say is true, providing it proves safe for Russell on an ongoing basis. As I have said before, if what is being offered is a placebo (and the evidence says Osteo is), then the risk/benefit equation is very different since benefit is in essence 0 then any risk gets magnified even if it is rare.But my point was that even if we assume it is a placebo, we know that Russell personally responds very well to that placebo. This is very different from looking at the risk / benefit analysis across the population.
For argument's sake, if you send N people to an osteo, and one of them drops dead within 24 hours, N/10 of them get significant relief and the rest are unaffected either way, you would probably conclude it was a dodgy proposition. And it would become even more dodgy if you saw the same N/10 response in a control group that was given sugar pills -- since then the osteo is doing actual harm, relative to the group who just took the sugar pills.
But if those N/10 people consistently see a response (and it was not just a spontaneous improvement that randomly coincided with the osteo treatment) and the condition was nasty enough you might conclude that the small risk of sudden death was worth it. And these are the "Russells"
However, what you would be less likely to do in those circumstances is send new patients to the osteo, but would just give them the sugar pills :-)
But I think we are talking about two slightly different probabilities.
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Ok, let's move on - how about the development and efficacy of western psychology and psychiatry? Institutionalisation anybody? Just been reading this great book...
Mad, Bad and Sad: A History of Women and The Mind Doctors from 1800 to the Present by Lisa Appignanesi ...
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As I have said before, if what is being offered is a placebo (and the evidence says Osteo is), then the risk/benefit equation is very different since benefit is in essence 0 then any risk gets magnified even if it is rare.
The benefit isn't 0. The point about the placebo effect is that it is *better than* doing nothing. There is some benefit. The question is whether most forms of alternative medicine function *better than* placebos. They don't, mostly, but that doesn't mean they can't perform a useful function, especially for quality of life issues. Depends on the level of risk, but as richard says, if that particular placebo has proven effective for your personal problem, then why not use it?
We just need to avoid pretending that it's because of qi energy or some magic other form of knowledge or whatever, because that leaves the door open to the idea that scientific medicine can be replaced with alternative medicine. And that's when you get people refusing to have their kid with cancer go through chemotherapy.
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Bumblebees cannot fly—or so physical models are said to have shown. That the insects routinely become airborne demonstrates the shortcomings of some theoretical accounts of the world.But one of the strengths of the scientific method is that, when presented with evidence that discredits their theories, scientists are forced to concede that their models are wrong and endeavour to learn from the failure. In science, observation always trumps theory, no matter how elegant the theory might be.
Emphasis added. From a recent article in the Economist. I'm not inclined to get into an argument with Peter Ashby, but I find it immensely frustrating when people argue that theory trumps observation, or that scientific theories invalidate what has been observed.
We just need to avoid pretending that it's because of qi energy or some magic other form of knowledge or whatever, because that leaves the door open to the idea that scientific medicine can be replaced with alternative medicine. And that's when you get people refusing to have their kid with cancer go through chemotherapy.
That's the tragic thing; those medical practitioners that refuse to admit the fallibility of their practice, and overstate benefits and understate side-effects are often the ones that drive people into the arms of those whose treatments have failed to deliver in even more consistent ways.
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You have been wasting your money, suck it up.
That does feel harsh Peter, particularly given it's Russell you're saying it to. His house and all that.
I bought a Lotto ticket yesterday, which my knowledge tells me doesn't make sense as a money making scheme. But I get something out of it, as does Russell with his treatment. If he feels its a good use of his money, and he's obviously informed himself about the realities of the treatment, up to him.
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That's the tragic thing; those medical practitioners that refuse to admit the fallibility of their practice, and overstate benefits and understate side-effects are often the ones that drive people into the arms of those whose treatments have failed to deliver in even more consistent ways.
I wonder how much of the uptake of alternative medicine is also because modern medicine can do so much that when it fails to deliver the expected miracles people turn to those who are willing to promise miracles. Knowing that so much is possible, it must seem hideously unfair when it's not possible for you - and so tempting to believe that it is, really, you just haven't been given all the options.
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I've been to many of the health specialists mentioned here and think the best were manipulative physiotherapists.
I haven't had acupuncture before. Call it an aversion to needles perhaps. I went to a hypnortherapist and gave up smoking (and it worked). I had a lifestyle change, shifted cities, stopped dancing almost every night of the week, settled down, went to lots of nice restaurants and put on 38kg. The hypnotherapy didn't work for weight loss - but 3 months of Jenny Craig and 4 years of hard exercise did. I took up soccer, circket and karate and became a volunteer fireman, so I had lots of injuries. The osteopaths were completely different in their treatment approaches. the first one I saw massaged my back for an hour before doing exactly what the chiropractor had done. The next time I saw an osteopath was after falling 5 metres of a roof and waking up in hospital. He was great. He firstly just put his hands over where I was sore and talked me into relaxing. I'd been stressed for months and it was the first time in ages I'd been truly relaxed. The pain left and I walked out feeling much better - skipping down the street better. How much of that was about the physical treatment - who knows. Did it work and was it worth $50? Short-term yes, long term who knows.
If I was really hurt, which I was quite often (2 broken ribs, badly mangled knee, broken hand and about ten twisted ankles, knees etc) I'd go to a physio and it worked. I healed much faster than I would have without going. The manipulative physio seemed from my point of view to offer many of the same services of an osteopath or chiropractor as well as all physio servces at a quarter the cost.
Hypnotherapy would have been an easier way to lose weight though! :-) -
I find it immensely frustrating when people argue that theory trumps observation
Theory doesn't trump observation, but I'll give much higher weight to an accumulation of methodical observations than to one or even several personal stories.
Also, when people give a personal account, there are two parts to it -- what they observed, and how they explained it. If someone says "I drank the elixir, and now I feel better, and the elixir did it, because it is made from powdered newts and the doctrine of signatures says it should work", I'll believe that they drank it, and I'll believe that they feel better, and I might even suspect that in a sense the elixir did do it, but I won't go on to believe the explanation without a great deal of corroborating evidence.
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In different words I'm going to repeat what I said - or rather what someone else said;
‘It is not truths or indeed their construction that we should examine, truths are subjective and relative. Where science is at its most powerful is when examining the usefulness of the truths we seek to employ’
This also echoes Richard’s point earlier.
It makes me sad that people so often smear the largely modest community of people that accumulate and test much the evidence and truths we use in everyday life. They do this by pointing to the antics of a minority who are for the most part: misreported or have grown reactive to the extraordinary misrepresentation that goes on around them.
Speaking as man who has built his career around evidence based practise how should I interpret this in terms of truth and usefulness ?
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