Will the Real Quacks Please Stand Up!

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I’ve never been much of a fan of alternative medicine and those peddling their cure-all treatments.  For one, their typical pitch being an attack an the profits of conventional medicine is actually a red flag about their own motives. 

And, secondly, testimonials (or anecdotes) are fabulously awful evidence.  A person can say anything they want or attribute their current positive feelings to whatever, but it doesn’t mean their A led to B assessment is actually correct. 

Unless there is concrete evidence, I dismiss the alternative quacks.  Sorry, I simply do not want to take or sell your mystery juice.  It is disturbing that so many can’t see through this kind of nonsense.

But what is far more disturbing?  

When the mainstream starts to resemble these frauds.  

Yes, it is obvious that modern medicine works.  My successful neck surgery as proof of this.  There were measurable results nearly overnight, almost immediate relief to pain and the numbness.  The whole process was very straightforward.  However, that was a cut and dried form of treatment.  In that they took the old broken stuff out, put some new hardware in, and gave my pinched nerves a chance to heal.  

And yet, while it is amazing what can be done, not everything in our human biology is as simple as disks and vertebrae. 

Indeed, there is a murkier side to modern medicine, things that aren’t 100% clear even after many years of study, having to do with the more complex parts of our physiology and how these systems interact, and this is something that must be explored.  More than that, however, our own psychology, tendencies towards bias, could be leading the collective enterprise in the wrong direction.

#1) Money Money Everywhere 

The first stop is profit motive.  If I don’t mention this then someone else will.  It is the low hanging fruit in this discussion and certainly a factor.  People need paid, and medical professionals get paid for treating disease.  Healthcare is a 4.1 trillion dollar industry in the US and pharmaceuticals are a significant part of that overall cost.  Does this mean that the medical establishment wants to keep us sick and dependent?

Public health officials and regulatory bodies are, indeed, potentially compromised by this opportunity to cash in.  Top US physician, Dr. Anthony Fauci had received undisclosed royalties, part of the $350 million paid by third-parties to NIH and scientists employed by this agency.  No, this isn’t itself proof of corruption, people should get paid for their contributions and lobbyists may very well believe in what they’re promoting.  But there is the reality that money can overrule ethics and potentially cause people to turn a blind eye to problems.

Still, this is not my go-to explanation and for the simple reason that this accusation could be made against any for-profit enterprise.  I work for a truss manufacturing company and we do profit off of fire jobs and wind damage.  Does that mean we intentionally set fires or build an inferior product so it fails every ten years?  Absolutely not!  To make such a claim is, again, more an indication of the heart of the person making it and not proof of anything unless there’s clear evidence.

#2) Testing 1, 2…Good Enough…

Testing and peer-review is also one of those areas of concern as well.  And not because there is nefarious intent either.  But more a matter of scope or methodologies. 

My neck surgeon, for example, opted out of being a participant in a study involving a new line of disk replacement hardware because it was comparing it to a far inferior older product rather than newer better products already available.  In other words, it was a stacked deck or research that is designed to lead to a particular conclusion.

That’s the big problem I have with these broad often unqualified “safe and effective” claims.  It begs the question: Compared to what?  Bungee jumping?  A placebo? 

Most people, including physicians and scientists, simply do not have the time to be experts at everything.  The body is incredibly complex and nobody can actually do their own scientific research for every issue.  For that reason those in the medical field must, as a matter of practicality, rely on diagnostic manuals for treatment and various journals to stay on top of things.  Coloring outside the lines, challenging powerful government agencies, doing unproven or experimental treatments, is a risk of their license or a malpractice lawsuit and ill-advised.  There is an inherent need for those employed in these fields to trust the system and accept what other professionals do. 

If not this, if  their training and education, what else are they going to rely on?

I don’t expect those employed in the medical industry to doubt the very foundation that they stand on. 

Unfortunately, this reality is what makes their consensus useless.  Sure, they might know much more than the average person about the science.  Still, are they up all night, in the laboratory, carefully repeating the results of the latest studies themselves?  No, when other experts in related fields endorse what another expert is saying it is merely a sign of statement of their faith—that being their faith in the overall system.  

But it seems every other week a study comes out that seems to contradict prior findings.  Most of this is due to how limited the focus of research actually is.  They can’t possibly test every variable and especially not in a very short amount of time.  This reality, of finite resources, is a legitimate cause for healthy skepticism and abundance of caution.  The problem is that most people, including those well-educated, don’t have great critical thinking skills or even the ability to know the right questions to ask—it is far easier to “trust the experts” and go with the program.

#3) Confirmation Bias Is Always a Problem 

The problem with research is that we often go in looking for a particular result.  Sure, a double blind study is designed to reduce this as a factor.  However, the underlying bias can show up as far as what gets tested and what does not.  It can also be a factor in how we interpret the data available.  Group think and echo chambers, things like functional fixedness, are as much (or more) a problem with those very knowledgeable as it is with anyone else.

One example of this is how “effective” kept getting redefined down.  What once was supposed to prevent the disease and stop the spread would shift, overnight, to being a way to merely lessen the severity of the symptoms.  Which is a foundation so subjective and shaky that it is basically in the same category of the testimonials used by snake oil salesmen.  It is another area where the studies aren’t as conclusive as many would assume.  And, at the very least, correlation does not equal causation.  In other words, the vaccines could simply be acting as a placebo for those who believe that they are effective. 

What is not taken into proper account is how these perceived benefits, that are shrinking day by day, weigh against both short and long-term risks. 

For example, someone very dear to me, fully vaccinated, boosted, is currently suffering from a persistent respiratory illness, starting a month or so ago, and now is having flu-like symptoms again.  Could this be this is a result of an immunosuppressant effect of the injection?  It sure does appear that way and would be worthy of a study of the things presumed to be unrelated to the vaccines that very well may be related.  There is only a trickle of information coming out, discussion of side-effects buried in the search results and censored on social media.

What is most unsettling is the reality that our mainstream medical establishment is as prone to confirmation bias as those pushing alternatives.  They see what they want to see in the evidence and dismiss or downplay anything that contradicts what they were expecting to see.  The biggest difference is that it is more convoluted than it is with the obvious quacks, whole institutions get on board with a solution and too often it just gets cycled through, reinforced in each cycle, without enough awareness of the potential failure due to the blinders we all wear.

#4) Political Bias Is Endemic

One of the most troubling revelations of the past few years was how awfully politicized the coverage of a pandemic was. Anyone who thought that partisan differences would disappear in times of a national crisis was dead wrong.  If anything it is what likely drove much of the response.  At first leading to charges of racism (for travel restrictions from the virus epicenter) and accusations of over-hyping the threat of Covid—before swinging wildly in the other direction with onerous state-level mandates that destroyed great economy on the eve of a national election.

But one of the most disturbing episodes (and disgusting) is how proven medications, like hydroxychloroquine and Ivermectin, were treated as if they were especially dangerous and controversial simply because the ‘wrong’ person mentioned their potential as being a treatment option.  It is truly a great way of explaining how propaganda works.  The partisan media would pick the most extreme case of an overdose, ridicule a proven multi-use medicine as “horse dewormer” despite the many uses, and then misleadingly ‘fact-check’ the technicalities of language.

I mean, sure, these proven medications do not “cure” the disease.  But they are most certainly treatments that are effective for preventing severe symptoms if taken prior to the infection taking hold.  This is why several older doctors that I know (whom I will not mention by name for their protection) were quietly stockpiling these much maligned substances.  They didn’t dare speak too loudly either or they would be risk their own medical licenses for promoting unproven cures or some other nonsense.  Bullying and peer-pressure is as real for a professional as it is for anyone else.

This, along with other much more expensive (and profitable) treatments being pushed, is fodder for the conspiracy theory crowd and for good reason.  For me it disproves any notion that the system we rely on, including the medical establishment, is impartial or fair.  Sure, I’m glad that The Lancet, a trusted medical journal, eventually retracted a study that falsely claimed that hydroxychloroquine led to death for some Covid patients (as they have with another study linking vaccines to autism) and yet the damage was already done.

#5) Lost in Oversimplification 

One of the harder or more difficult problems to explain is how the common models of are often too dumbed down to be accurate.  

Up until recently depression was explained as being “chemical imbalances in the brain” and selective serotonin reuptake inhibitors (SSRIs) the solution.  This overly simplistic explanation has been called into question and this is a cause of alarm for those told to “trust the science” when it comes to the professionally prescribed answers.

I love metaphor and analogy to explain things less visible or intuitive.  However, if these tools are misunderstood as being exactly the same as the thing being described this can lead to very wrong conclusions. 

Just like a ball and stick model of atoms is useful yet doesn’t truly explain the reality (an electron is more cloud of probabilities), the various illusions used to sell parts of the pandemic response are as flawed.

Sure, the theory of “flattening the curve” is great on a graph, and swiss cheese makes a very compelling illustration of how a multi-faceted approach could work, in theory, but both give a false impression of being complete or unquestionable. 

But is this theory working in reality?

Of course, how diseases spread in the real world is different from the even the best models and it is quite possible that slowing the spread only makes things worse, as is the case with attempts to manage forest fires. In that effort to control can eventually lead to much more devastating fires. Slowing down the process could result in a scenario where the burn is thorough, everything gets consumed, rather than the alternative of a fire that moves quickly and skips over areas.  The point being that analogies don’t account for the nuances and could lead to the wrong ideas taking hold in the public imagination.

No, this is not to claim that I have a better grasp of virology than those who have studied these things their entire lives.  It is only to say that these illustrations give too many undue confidence.  There are many factors that these crude analogies gloss over and factors that could vastly change the final outcomes.  The problem is that many are unable to see the more complex picture as a result of these elementary level descriptions that are used to sell a particular approach.

It makes us unbalanced.

In Conclusion…

There is no individual that can provide an opinion that is completely infallible nor any agency that is able to offer a perspective free blindspots or bias. 

Our “settled science” today make seem as bloodletting in a generation or two.  And the same kind of thinking that leads crackpots to their ‘alternatives’ is also all too present in the mainstream.  There is always the money motive, with the lack of adequate testing, the confirmation bias, the influence political agenda and faulty or misleading explanation, all tainting both the perception of the general public and professional opinion.  The biggest difference between those who believe the quacks and those who insist that the vaccine is effective is the level of funding behind their perspectives.

This doesn’t put the outliers and mainstream on equal footing, there is such thing as strength in numbers, yet what is popular is sometimes only a product of propaganda and common ignorance. 

Don’t be so sure that the things being ridiculed in the current paradigm are any different from what is being promoted.  We know less than many think we know.  There may be future studies or new discoveries that will completely upended the too hasty conclusions of our time. 

No matter how confident we are in our own position or settled we believe a topic is, it is always best to stay humble.

A Mixed Bag of Medical Results

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Part of my personal myth is that I was a “miracle baby,” spared from a very early demise by the medical intervention of nurses and physicians, including my uncle Elam, a pediatrician, who hand pumped air into my lungs while being transported to Geisinger Medical Center.  

I had been born premature, suffered from a condition called Hyaline Membrane Disease due to my underdeveloped lungs, suffered a collapsed lung due to my hard breathing, and likely would have died without the advanced care that I received.  I was a fighter, for sure, but my survival would depend on the skilled intervention of medical professionals.

My mother would tell me that story and also use it to remind me that God had a special purpose for my life.  But what she didn’t tell me, until much later, is that my early trauma was actually caused by her doctor who induced labor. 

Oopsies.

My Medical Family

My mother had aspired to be a nurse.  Even worked in a nursing home prior to marrying my dad.  But life, including my sister and your’s truly, changed her plans. 

However, as often is the case, these dreams of parents are sometimes fulfilled by the next generation and sometimes double.  Both of my sisters are employed in the medical field and eventually even my mom found her way into a doctor’s office before eventually playing an instrumental role in the opening of Compassion Parochial Clinic.

My own role in all of this was to be my eldest sister Olivia’s first patient.  Using her Fisher Price Medical Bag, she would check and treat my various imaginary ailments, and had her mind set on being a pediatrician like her well-respected uncle.  And, after graduating high school, then acquiring a biology degree, she continued her education at Albert Einstein College of Medicine on Bronx, NY.

In fact, l feel that I may deserve a partial credit for having attended a lecture on the heart.  Although, I may have missed the second half due to a terrible bout of drowsiness and was not the only one sleeping.  Although, as a courtesy, I will not say whether or not my sister had succumbed.

Anyhow, my younger sister Lilian also picked a medical career, eventually became an RN, continued her education, and is now working on her licensing as a midwife.  Her passion is welcoming babies into the world and is someone with a personality well suited for the job.

All of that to say that this exposure causes me to have deep respect those in this profession.  One way to get on my bad list very quickly is to suggest that those in the medical field are only in it for the money and would deliberately keep people sick to cash in.  Sure, there are bad eggs in every profession, some terrible doctors, but my sisters (like many of their colleagues) are there to help people get well.

That said, having family in medicine also removes some of the aura.  My sisters are far more qualified to give opinions on medical issues than I am and yet they also are still human. 

Doctors make mistakes, they’re fallible like the rest of us, with blindspots and bias.  Plus they’re used to having totally ignorant people, who “did their own research,” challenge them on things they’ve spent years of their life studying, and can become tired of answering these inane statements—appear arrogant.

Physician: “Heal Thyself…”

People have very high expectations in regards to modern medicine.  We’re supposed to go to the doctor and be completely healed. 

But the reality is quite different from that.  Once you get past the buzzing technology and laboratory developed chemical cures, the sterile well lit halls of institutions, our actual abilities are still quite primitive.  Science may have given us better bandaid solutions than were available to our ancestors, yet there really aren’t that many miracles to be had.

My own expectations have lowered considerably after two injuries requiring expert examinations.  

The first, diagnosed as Degenerative Disc Disease, brought me to the office of the renowned neurosurgeon, Dr. Rajjoub.  I had terrible pain, loss of strength and feeling on my right side, my neck was really bad from what my family doctor saw on the MRI.  My parents, after we waited what seemed hours, finally were escorted into the examination room and were full of anticipation.

Having done our own research, knowing the seriousness of my injury, it was quite certain that I would be under the knife soon.  They would open things up, remove the bad, and fix me up better than new!  

The physician strode into the room.  He looked over the charts and images with intensity and then, without hesitation, “physical therapy” and started to turn towards the door.  Stunned, my mom, speaking for the three of us, our mouths agape, “Wait, what?!?”  It was as if he just told a blind man to rub mud in his eyes and was simply going to leave.  He explained further, telling us about the risks of the procedures, how my neck movement would be limited after, and restated his recommendation.

Dr. Rajjoub was right.  After weeks of therapy and further exercise at home, I was able to regain feeling and the use of my right arm.  Sure, I occasionally have painful flare ups and may need the surgery some day, but the doctor had given me the right answer even if it was not the one that I wanted to hear at the time.  Modern medicine has advanced, yet it is our body that still does most of the healing.

A Comical Contradiction

After tearing my ACL I met with an orthopedic surgeon to discuss the options available.  Still active, I expressed my desire to get back in the game and he responded by recommending surgery.  They grafted a part of my hamstring tendon in where the ACL had been and I spent the next few months becoming good friends with Rob and Bob at Keystone Care Physical Therapy and impressing the old folks there with my vertical leap.

Unfortunately, after a year of intense rehab, I was playing basketball and reinjured the repaired knee.  So I went back to the orthopedic surgeon for a consultation and his advice?  He suggested that maybe I slow down a bit, that I was no spring chicken anymore (a paraphrase) and should probably avoid strenuous activities.  Excuse me?!?  I had thought I went through the surgery and physical therapy so that I could actually use the limb, right???

But that’s typical of a doctor’s advice.  He was trying to minimize the risk of my reinjuring my knee, to cover his own butt, and could I really expect him to say anything otherwise?  To tell me to go full throttle again?  I can understand why he would urge my caution.  And still I can’t deny being disappointed.  My thought had been that this surgery would allow me to pick up where I had left off and instead I got a cease and desist notice.

The Undiagnosed Nightmare

I’ve reconnected with an old school friend.  I rode the bus with him for many years and we shared a first name. 

It is quite astounding, actually, how we got reconnected.  That being a story for another time.  But one thing memorable about this old classmate is how he was always complaining about pain in his feet.  At a younger age I had thought of him as being weak or a whiner.  He had been diagnosed as being flat-footed.  

However, it was a little clearer that there was something more seriously wrong when, in middle school, a fall, after a playful shove in the hall, resulted in a broken hip.

Anyhow, at our one-on-one reunion he would let me in on his the true source of his suffering and something that the medical professionals had missed.  Something that doctors had initially told him was all in his head, that the genetic department of an area research hospital refused to even test,  turned out to be Fabry’s Disease, a rare genetic disorder where the body is unable to produce a particular enzyme, which means the body is unable digest certain proteins, and is a death sentence if not properly treated.

He had gone through hell.  A breeze on his skin felt like torture.  They had treated him with addictive painkillers that basically turned him into a junkie.  And his proper diagnosis came from an uncle who read a story about someone with similar symptoms, a revelation that prompted my friend to demand the diagnostic tests for the genetic disorder and only then did he finally receive the necessary treatment.  The medical system had both failed and saved him.

The Miracle Hoped For…

Then there’s my cousin Uriah.  Nothing, not the most advanced treatment in the world, could save him.  The prognosis was never good, Synovial Sarcoma, but I held on to the hope that some new cure might come along, some miracle might happen, and he would survive.

It was hard to watch.  First after one round of him taking poison, called chemotherapy and the only thing that will keep the corrupted human cells called cancer from growing, they decided that he would need to sacrifice his leg.  This Uriah and his family did everything they could, he received top notch medical care at Walter Reed and elsewhere.  But there was not much that could be done for him.

The limitations of modern medicine is a bitter pill.  And those seeking ‘alternatives’ do not fare any better if diagnosed with an aggressive form of cancer.  I know many strong-willed individuals, in partial denial of the graveness of their condition, who traveled to places like Mexico for some kind of breakthrough treatment and suffered the same fate.  Better technology may come along soon and yet disease and death is as natural as health and life.

There is a myth, popular in some circles, that if a person eats right and exercises they will be rewarded with long life.  Uriah was one of the most fit and disciplined people I know, there was nothing he could have done better, he was dealt a bad card.

Having Correct Expectations

We see the headlines, “The third-leading cause of death most doctors don’t want you to know about,” discussing medical mistakes, like this one:

“In 2002 James lost his 19-year-old son after he collapsed while running. He had been diagnosed with a heart arrhythmia by a cardiologist a few weeks prior and was released from the hospital with instructions not to drive for 24 hours.

“His death certificate said he died of a heart arrhythmia,” he said, but my son really died as a result of “uninformed, careless, and unethical care by cardiologists.” He explained: “If you have a patient with heart arrhythmias of a certain level and low potassium, you need to replace the potassium, and they did not. And they didn’t tell him he shouldn’t go back to running.” Communication errors, he said, are “unfortunately very common.”

What is left out of this story is that a century ago he would have simply died from the arrhythmia. 

In fact, only half a century ago my great-grandfather died, a middle-aged man, of a heart attack because there were no surgeries widely available. 

So, truly, modern medicine is a victim of it’s own success, things have improved so much from the time when many people died of many diseases, even at a young age, that we now expect perfection.  Our ancestors, not too long ago, would have no treatment options, whereas we demand answers when the treatment fails.

Those who expect too much will be the most sorely disappointed.  Those who expect to be saved from suffering by science will some day be faced with a harsh reality and, likewise, those who believe that there’s a cure for cancer being withheld are equally delusional.  This idea that we have complete control, that there should somehow be a cure for everything, is a product of our success in medicine and also ignorance of what this success actually means.  

Sure, some of us, like my grandpa, may have died on multiple occasions had it not been for medical advancements like Penicillin, prostrate surgery and pacemakers.  But, even now, with the great progress we’ve made, we’re still all eventually going to wear out.  Our bodies have a shelf life and all the intervention in the world isn’t going to do much to change that.  Eat healthy, exercise enough, avoid getting hit by a truck, and you might see eighty years, maybe more if you have good genetics.  But we won’t live forever.

So, before we become too critical, rather than only dwell on the failures, we should look at the advancement and appreciate the success.  Results will always be a mixed bag, even those who have received the very best care, men like Steve Jobs, do not live forever nor will you.  Even Lazarus, brought back to life by Jesus, eventually died.  And my friend, the one with the missed diagnosis, would long ago have joined Lazarus had it not been for modern medicine.

Vaccination and Causes of Nepal Earthquake

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There was an earthquake in Nepal several weeks ago.

Most would probably agree that earthquakes are caused by sudden movements in the earth’s crust and are satisfied with a scientific explanation.

However, some are not satisfied with that and turn to more creative interpretations of the ground shaking phenomenon.

One man, an Iranian cleric, claimed earthquake is linked to promiscuous women and gave Islam as the solution.  Another woman, a Hindu, offered this explanation: “Rahul Gandhi eats beef and goes to the holy shrine without purifying himself, the earthquake was bound to happen.”  And, finally, a US pastor, wrote linking topic of pagan shrines and the earthquake.

So, three different people representing three different religions and three different reasons why the earthquake happened.  However, all three have in common a similar logic.  They share an idea that one thing was happening (promiscuity or meat eating or paganism) and therefore the next thing (an earthquake) thing happened.  It is the logic of correlation implying causation.

Those who study logic recognize the potential logical fallacy.  The correlation does not imply causation in this case nor does it in others like it.  It is completely possible that the earthquake would have happened regardless of what people did or did not do.

And, until a person can provide good research that links one to the other, it is not reasonable to conclude a link exists between earthquakes and immorality.

Blaming Vaccines For Childhood Developmental Problems

Vaccines have become fodder for the same type of thinking that blames immorality for a geological phenomenon.  If a child is vaccinated and later a disability or medical condition arises some parents will attribute it to the vaccines.

Parents trust their own perception.  From what they can recall the problems did not begin until after the vaccination and therefore must be somehow linked to the vaccine.  In their search for a link, many will take anecdotes as evidence and proof of a link.  Unfortunately, even a hundred anecdotes showing one thing happened after another is proof of nothing besides sequence of events and not even suggestive of a causal link.

It would be no different from me telling a story of how a friend changed the oil in his car and two weeks later the engine blew up.  Sure, there could be a link between an oil change and problems that develop later in a few cases.  For example, if the mechanic left the oil plug loose, the plug fell out, the oil drained and, without lubrication, the bearings seized.

However, that doesn’t mean a recent oil change caused the headlights to burn out in your own car.  Even if a dozen other people had mechanical breakdowns happen within weeks of an oil change there’s still no proof of a link.  And the same is true of vaccines and disabilities or medical conditions that develop later on.  The link we make between two events is not proof that one caused the other.

Yes, there is possibility vaccines have side-effects, many solutions do have unintended consequences, but that doesn’t justify the assumption that anything that happens after a vaccination is caused by the vaccination.  A link needs to be established that explains step by step how one leads to the other or it is nothing but speculation.

A Desperate Search for Explanation Leads Misattributed Blame

It is understandable that a parent would blame something like vaccines for anything bad that happens afterward.  The idea of sticking a child with a needle seems unpleasant and unnatural to begin with.  Add to that the general mistrust of educated people and profitable endeavors in some circles.  But, be that as it is, sometimes seemingly healthy children hide problems that would develop later on whether they vaccinate or not.

I know a family who had a child that appeared healthy and later died after a series of seizures.  Since the problems started some time after being vaccinated they decided not to vaccinate their future children.  Their unvaccinated second child was completely healthy.  If I stopped there that could be mistaken as evidence.  But, sadly, it wasn’t that simple, their next two unvaccinated children developed similar problems to the first vaccinated child.

Most of us probably understand the absurdity of trying to pin the blame for an earthquake on eating meat or un-Islamic behavior or pagan shrines.  But many do make the mistake of confusing correlation with causation in other areas.  We need to be aware of our own vulnerability to this type of thinking and be on the lookout for the fallacy: Correlation does not imply causation.

As enticing as an explanation is, bad logic does not trump good science, and we need to know the difference or we will be blown about by the winds of our feelings and intuitions.