As part of my assignment for my course in bio-medicine I was asked to give my understanding of the relationship between conventional and complementary and alternative medicine and the issues that we need to be aware of when using complementary and alternative medicine alongside western medicine.
I thought I would share my essay here.
Needless to say I think allopathic medicine is in very bad shape. In 2013 Forbes once again reported on the crazy amount of people that die in American hospitals due to preventable deaths. The article can be read here. They estimate the amount of deaths, due to preventable causes, at 440 000 per year which apparently places it at, leading cause of death, number three.
Naturally the situation in South Africa is ten times worse.
The essay limitations were frustratingly short. We had to make our point in 400 words. I don’t think I have ever been able to make my point in 400 words. Obviously I also did not succeed this time :-).
So let me copy and paste the thing and end with one or two clarifications. This is my own opinion and does not reflect the opinion of the college of natural health.
(Start of essay)
To understand the relationship between conventional science and complementary and alternative medicine we must have an appreciation of the failures of, the allopathic medicine, that resulted from conventional science. I will not dwell on the high number of preventable deaths resulting from allopathic care in hospitals. Although this is a major concern alternative but comparable problems can conceivably be found for complementary care.
The biggest conceivable deficit of allopathic care is its insistence upon objective evidence that can be replicated and its refusal to even consider anecdotes. One only have to ponder the fact that the etiology of more than 90 percent of illnesses are extremely poorly understood to appreciate how patently absurd this approach is. For the sake of argument I will give one example but it cannot be overstated that thousands of examples can be imagined.
Let us consider magnesium as a treatment of headache (magnesium has been established to be effective in treating migraine). Imagine a hundred people presenting with headache. Now imagine that of those hundred people 10 have a headache that is related to Magnesium. However 3 of them have conditions that make it difficult for them to absorb Magnesium. When compared to a placebo in a double blind randomized trail it is obvious that Magnesium will not fare much better than the placebo. Add to that, the fact, that paracetemol disrupt prostaglandin synthesis 99 percent of the time and one cannot help but feel that Panado will forever remain the GP’s choice :-).
Also it cannot be overemphasized that medicine is the “ultimate seller’s market” (thanks to Steven Brill from Time magazine for this analogy). Since “randomized controlled trials” cost a lot of money the only people who are willing to invest are ones who will make a profit. Even if we exclude the biased results that everybody believes exist but refuse to disregard we must still appreciate that the amount of “things that work” are extremely limited. Since the “clients” are in an extremely weak position to negotiate this results in absurdly inflated prices because there is no “healthy” competition. Finally add the extreme regulations placed on medications, by governments, and we can only throw our hands up in the air.
I believe that while there is a place for medicine and complimentary medicine, side by side – a strong, eagerly focus on reconciliation misses the bigger issue. Allopathic medicine needs alternative care to keep it in check and to fill up the massive gaps that it leaves in its wake. Since the internet lay people and alternative healers who don’t have money to publish have been able to share “anecdotes”. This has resulted in an explosion of “possibilities”. I.e. – “this has worked for me – try it as long as it is safe for you.” This approach makes much more sense given the above mentioned poor understanding of the etiology of disease.
So alternative modalities exists as:
- A necessary buffer for the gross financial indulgence of the allopathic system
- An anecdotal alternative or complimentation to the lack of results in obtaining a “cure” for disease
- Frequently to provide safer alternatives that have not been “proven” in cases where the outcome of allopathic techniques is understood to be “limmited” either way or “simply not worth it”.
The only thing necessary for alternative healers is humility to incorporate a diagnostic opinion from a professional and, all be it anecdotal, knowledge of the limitations of their products as well as knowledge of possible interference with allopathic approaches. If this can happen we have a good thing coming.
(End of essay)
I don’t think the average person understands how poorly the causes of disease (etiology) are understood. Apart from infections and gross undernourishment the rest is a bit of a “haze”.
What bugs me, a lot however, is when the etiology is partially understood and doctors are not ‘allowed’ to act on it because it is not “guaranteed” to work because there is not enough evidence. Doctors have become ‘priests’ that tell people what they ‘must’ do in order to achieve ‘everlasting life’ instead of being ‘trusted friends’ who give expert advise within different contexts.
For example the whole sodium-potassium and hypertension thing. We have understood for a long time that cutting back on salt reduces hypertension for some people. And we have long known that conditions that increase sodium retention and potassium secretion results in hypertension. What is not so well known (at least by me) is how much the diet involvement of lots of sodium and almost no potassium plays into this. Can we even attempt to treat hypertension by supplementing potassium instead of cutting back on table salt? If you have the time visit the site watercure.com based on the work of Dr. F. Batmanghelidj. This remarkable guy discovered the effects of drinking water on histamine and sodium/potassium balance. The site can be found here. Naturally his theories do not cover every disease under all circumstances but it is telling to me that his theories never even made it to a discussion during med school.
Also consider this story here about a woman who developed hypertension while drinking too much tea with liquorice. What frustrates the living crap out of me is that she had to go a homeopathic web site before receiving the information that she needed. And I actually remember being taught that liquorice is an important cause of low potassium and blood pressure. However the approach that we were taught is to walk through these things if the blood pressure remains uncontrolled despite treatment or if hypokalaemia develops. Not that I think most doctors even remember the relationship five minutes out of med school.
So while I am weary of the absurd promises that some natural healers make, my experience is that most people are capable of understanding the principles of health and discerning the shit from the shoes. I think the amount of money that is spent on ‘keeping antibiotics regulated’ is not worth the one or two people that ‘die from resistant infection’. Frankly, I believe, most of these got the majority of their antibiotics from doctors anyway. Will ‘smart’ people, who are educated about the dangers of antibiotic overuse, really bugger themselves up by causing resistance through taking an antibiotic every time they have a runny nose? Right now a good (3rd of 4th generation) antibiotic will cost you 250 to 350. A private GP appointment is another 350. Symptomatic efforts and herbal support together with one or two cheap supplements can come close to another 200. Conservatively speaking a ‘bottom priced’ doctors visit will net you between 600 – 800 rand. Now, as far as I know, in a place like India antibiotics are apparently not regulated. Are they struggling with the prophesied resistance? And in India antibiotics are a tenth of the price in South Africa – even the expensive ones. Nobody their dies from medicine not being accessible economically. I think. Of course I did not research this – I am just venting :-).
The price of maintaining ones health has become very unhealthy. At the same time the advise you can expect from doctors consists of an elaborate system that, at best, will most of the time only succeed in managing your symptoms and makes it possible to ‘carry on with a normal life while remaining sick’. Of course I do not subscribe to the conspiracy theories that says this is all planned. Sure money motivates the majority of research efforts but no – not every doctor is a self identified nihilist who cares nothing for anybody other than him/herself. Most doctors really want to believe that they are making a difference. And in a way they do but fuck – people are dying and as the stats show – often because of doctors. The only thing left for someone like me is to spend the rest of his life looking for an acceptable solution to the problem because to me ‘balancing the energy and vital forces of your body’ is just not gonna cut it :-).
But at the moment we desperately need alternative medicine to fill up the gaps. It says a lot when the causes of disease are almost never understood but the only treatment that is ‘deemed acceptable’ is the kind that is ‘proven beyond a shadow of doubt’. What surprised me, when I wrote this, is how logical it all sounds. If we are going to tackle a process that we do not understand surely we have to experiment with what we do not understand? That is if we want real and lasting results. And, for sake of all things good, can we at least consider that anecdotal stories sometimes contain a shred of truth in them?
I cannot be the only one who has ever thought of this?!
I would have been proud at the thought if the results of it wasn’t so sad.
But more than alternative medicine – we need people to share anecdotes.
DO NOT BE SCARED OF THE INTERNET
The problem is – what you do not know may also kill you.
In my mind we only have to discern the immediate safety of a product before we start to ‘experiment’ with it. Of course ethically you have to establish that something is safe first. Usually this happens on rats first.
But fuck that. Not the rats :-).
We are dying and our Priests are killing us. Albeit not on purpose….
I really think so.