The Day Alternative Medicine Dies

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I loved the movie Big Hero 6. If you didn’t watch it, you should because it’s joyful and adorable and it has a snuggly robot. And who doesn’t like snuggly robots? Terrorists, that’s who.

But my point, and I do have one, is that the big snuggly robot, Baymax, was originally created to be a medical care robot. He’s part nurse, part… non-edible marshmallow man, if you will. It’ll be amazing when science can build a robot that can pop out of a box and diagnose you. Have strange symptoms? Dr. Beverly Crusher whips out the tricorder. Have a doctor shortage? Build snuggly robots and have doctors for when patients need the human touch (or for surgeries for when robots- or humans- are broken) Think they’re wrong? Good luck with that; they’ve finally got this medicine thing nailed, and they ‘ll be able to treat you too fast for you to doubt them. You’ll come around in no time when you just no longer get sick. Homeopathy, mystic crystal healing, and whatever the fuck Deepak Chopra is ranting about this week are all gone.

It’s amazing to hope that one day this could be reality.

But man, science is just not there yet. Not even god damn close.

I bring up robots because I attended DARPA electronics conference last year, and the tasks they give the robots are basic. Open a door. Pick up a screwdriver and drill a hole in a piece of plywood. Walk up stairs. They complicated this a few levels by simulating a disaster zone in which the robot was designed to operate. The results were that sometimes the robots made it through this obstacle course completing these handful of tasks and the engineers who worked on this for a year were joyously happy.

But sometimes… epic disaster.

One of the most entertaining things to come out of the weekend was a video compilation of multi-million dollar robots falling disastrously, much to the horror and distress of the engineers who were, presumably, living on Red Bull and shattered dreams. Entertaining to us, tears for them.

What does this demonstrate to me? Doctors are at the same state of advancement as these robots. As technologically advanced as we are now, doctors and scientists still epically fall.

How does that translate for the human being who’s in pain, suffering and looking for answers via Google MD because they can’t find them via their doctor?

This weekend I was at SXSW on a panel with James Hamblin from The Atlantic, and he pointed out (paraphrasing) that alternative medicine may be born out of the shortcomings of the medical system.  It’s a good point. Doctors are good, the best resource we have for helping keep people healthy. But they’re also human. They’re flawed, they have biases, and they’re also working in a system that limits their time and resources. They are limited by what science currently knows, how fast clinical trials can move, the regulations in the system (that are designed to keep people safe but sometimes keep medicine away from desperate patients), and the sad reality?

Sometimes the best, most intelligent doctors with all the training in the world, look a patient in the eye who’s suffering and desperate for answers, and despite all their training, just don’t goddamn know.

I’ve been one of those patients more than once in my life. I empathize.

I’ve mentioned before that it’s sent me looking for answers outside of mainstream medicine (while still working with my doctors) because I was vulnerable and desperate. Even for a well educated person, desperation and vulnerability will send you hunting in the bowels of the internet for alternative answers when conventional medicine fails.

Right now you go into the doctor’s office and you have some weird set of symptoms that’s hard to diagnose. Something’s not showing up on scans, there’s no way to measure what’s happening in your body. Six different doctors give you six different answers, and doctors legitimately have to struggle with limited time and resources that they’re juggling between you and all their other patients to figure out what’s wrong. It’s all in your head. The symptoms point to a rare ailment, but it can’t be the rare ailment because it’s rare (true story, I’ve been told this). You just need to exercise and drink less caffeine and it’ll all go away even though there’s nothing in the medical literature to suggest that’s a cure for this. You’re too young to be in this much pain. Let’s treat for the easy thing even though it’s probably not the easy thing just because then we can rule the easy thing out… even if that’s just wasting your time, money, and another month of pain.

The symptoms are all over the map, what one thing explains this many things?

Or can one person have multiple things wrong with them?

Do we even have a test for this yet?

You, a presumably honest patient, are at the whim of a doctor who’s dealt with twenty other patients today. Some thought they were dying from a cold. Some were drug seeking. Some looked like they were drug seeking and were legitimately miserable and doctors are bad at telling the difference. Some patients left with antibiotics for a viral infection. Some left with no answers at all.

Life is not fun when it’s been turned into your own personal episode of House. Entertaining TV, tears for you.

And then skeptics occasionally have the audacity to tell people who turn to alternative medicine (even something as ridiculous as homeopathy with no fucking medicine in it) that they’re silly for not trusting doctors 100% of the time.

(Just a reminder from Tim Minchin, this is not my endorsement of alternative medicine).

10171022_677139195689426_3608653601323479551_nCredit: Refutations To Anti-Vaccine Memes

Doctors are great, but they’re also fallible. They’re only as good as the answers available to them.

What happens when, one day, all the answers are readily available?

How much harder would it be for an alt med practitioner to step in if we lived in an era where little Baymax from Big Hero 6 was real? Or even before Baymax (given the epic robot fails at DARPA, it’s pretty far off), what happens when the medical system evolves to work  a lot better?

What happens when we have a name, a rapid test, and an ability to manage every disorder? Medicine gets better every day, but there are still diseases that sometimes take five years or more to diagnose. Some diseases take years to struggle with medications to manage. What happens when we have readily available and affordable testing at birth for all diseases, when we can track the courses of disease with the touch of a button and automatically change the course of treatment? What happens when the pharmaceutical industry has gotten so much better that we can figure out what medication to give you just by scanning you… and the drugs’ effects are better than the side effects.

Where do you think the alternative medicine racket will be then?

Technology is advancing all the time, and we can’t get enough of it. Boston Dynamic recently showed off a new robot that- in true Boston style- can handle getting beaten around with a hockey stick without falling down epically… It’s better than the robots-of-the-engineers-misery in the videos, but it’s also not Baymax. You think tricorders are just for Star Trek? Nope, they’re real and they’re fantastic. They’re a lot better than a stethoscope, but they’re also not the instant-diagnose-everything-machines that they were in Star Trek.

Technology and medicine are getting better. The shortcomings in the medical systems are going away. Doctors are increasing their knowledge base with both technology and research. And one day, when six different doctors can all look at the same patient and use technology and our knowledge base to diagnose a patient perfectly and consistently, alternative medicine will see its last day.

Until then, I’m still dreaming of Baymax and telling people that homeopathy has no fucking medicine in it.

 

-SciBabe

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16 Comments

  1. Ah, the joylessness of a non-diagnosis, where a test came back negative, the misdiagnosis numbers mount.
    My wife has Lupus, just such a case, as it masquerades as multiple ailments and most immune titers won’t read until an attack is happening.
    Since her diagnosis, a wave of members of her family have been diagnosed, some had extremely serious problems, such as pericardial tamponade.

    I’ve had a physician, an Ashkenazi Jew at that, tell me that I couldn’t have Reynauds, even after seeing the effects on my hands, “Because you are a man”. I asked about Ashkenazi Jews and the much higher level of rheumatoid arthritis, in men as well as women. After the shock wore off, he concurred.

    Medicine is a science and like any other science, discoveries come in one of two ways.
    One, the sweat and toil of repeatedly trying to ascertain how to test a theory, to develop a test, to find commonalities between different things.
    The other, during an experiment or measurement, “Hmm, now this is odd. Just what is going on?”. Remember the “junk” DNA? Now, some mutations are linked to disease. Yes, it’s supposed to be non-coding, save that it alters things in a deleterious way. How it effects things was yet another discovery, more of the first type than the serendipity.
    Still, it comes down to two things, a bit of brilliance and a hell of a lot of long, tedious work.

    That hard work produced produced methimazole, which is slowly get my hyperthyroid under control before it kills me. It was approved in 2001.
    Metoprolol was approved in 2007 and it’s literally saved my life, as I was well into atrial flutter and my aorta is dilated by 2.2 cm. Aortic repair is also a real thing now, with its inventor’s life being saved by the same surgical technique that he developed and now, we have catheter based repair, to repair the vessel via endovascular means, rather than carving a patient up and have a lot of blood loss and infection risk.
    Who knows? In a few years, they might come up with pills to stop and prevent people from being assholes.
    Nah, that’ll never happen, it’d be like having men walk on the moon!*

    *Men did *not* walk on the moon. They shuffled, they hopped, they fell down a hell of a lot. It’s the moon, with tiny gravity. Walking anything like you’re on Earth is not in the cards.
    But, doing all of that falling only adds to the accomplishment in traveling there with such primitive technology, as the space suit was overdesigned to permit those falls without a breach.

    • I know this is an old post but I just found the wonders that is SciBabe. I might have Lupus, or something, they don’t know yet. But it did take me 11 years to get diagnosed with Ehlers-Danlos Syndrome and a mild case of what could be MCAS and I’ve been showing symptoms for 11 years and 3 years respectively. I get your pain, struggling through pain and diagnosis suck

  2. That hyperthyroid?
    Well, it seems that my immune system took a dislike to my thyroid and attacked it. In a huge snit, my thyroid counterattacked and I got caught in the middle.
    As soon as my T3 and T4 levels are somewhere in the human range, I intend to take my immune system and thyroid out behind the woodshed, bringing a nice hickory switch.
    TPOAb is fairly high, but a bit under 1000, but the lab initially performed the wrong tests and miraculously had my blood still available the next day and the TRAb was negative.
    Holding a blood sample overnight after the tests were performed is rather unusual, I never heard of it at Temple University Hospital when I was there.
    Regardless, that thyroid better behave itself or I’ll be referring it to HR for disciplinary action, right along with my immune system!

    Were it that easy…

  3. Hi
    I fear that regulating medicine is a more demanding task than it is to regulate quackery. A deepak chopra random quote generator app is much easier to build than a Baymax bot 🙁

  4. I am, at my heart, a scientist. However, I can’t fully reject alternative medicine.
    This is why.
    I have a dog. She’s a fancy champion-lined purebred that someone ditched at a vet clinic and therefore was given away Free-to-good-home. She also has a LOT of problems. We went to regular vets. We went to specialty vets. They all insisted on more or less the same treatment when she had a flare up and insisted on the same Dx. The treatments didn’t work and often seemed to make her sicker. In a last ditch “if this doesn’t work we put her to sleep” effort, we saw a holistic med vet.
    She did new blood tests and biopsies…different than the other docs… and came up with a new Dx. She also had a new treatment regimen. This worked. It wasn’t a cure, but it does keep it under control with minimal flare ups. The accupuncture and massage seems to help with the anxiety issue. The new diet is free of the food her body can’t tolerate. and the daily benedryl helps with her allergies. Yes, benedryl is a regular med, but the dog is allergic to one of the herbs in the herbal remedy.
    We also had another dog that reacted poorly to standard meds (another fancy purebred) but had zero problems with the herb mixes. And they worked.
    But holistic doctors, at least those that practice both regular medicine and alternative seems to be more open minded. I’ve found they, for people too, seem to do a better job finding a real diagnosis and effective treatment. Because for some ailments, all you can do is treat symptoms. So, if something odd gives relief, it’s worth it.

  5. I had an uncommon shoulder dislocation. It started with just pain, a lot. Scan looked horrible: arthrosis in the homerus, several tendinitis, glenoid ligament degenerated and so on.
    No apparent cause, no trauma and actually the first two doctors that visited me could not find a dislocation.
    After a year in distress my father forces me to see a Chiropractor… First thing i notice: a book about urine healing over her desk, I keep my mouth shout. Then she start doing weird things with my neck, I get annoyed and abruptly stop her. So she starts rambling about my liver, being “too big” for eating too much fats and pushing on my shoulder. Since it was my left shoulder I’ve almost punched her. And so ends my story with Alt. medicine. I still have the urge to beat the crap out of any friggin healer.
    (N.B. It was a back dislocation, paired with congenital hypermobility and a poorly angled glenoid process. After three years
    got lucky to finally find a surgeon with a peculiar experience with that kind of dislocation)

  6. I am an older physician and am also a patient who has dealt with a serious disease which is now fortunately in remission. I think that it is important to understand that because of bio-variabity and the fact that the human body is a complex system, coupled with the fact that present medical knowledge is limited, medical decisions are usually made based upon probabilities and not certainties. If, based upon the best information that we have to date, the benefits of an intervention are likely to outweigh the risks, that intervention is recommended. The patient should be offered the chance to assess the evidence that leads to the recommended intervention to the level that they are able to based upon their biological knowledge (as long as the delay necessary for them to assess the evidence is not clinically relevant). If a “practitioner” tells you that something will definitely cure you and has no data to back it up, you can safely assume that the “practitioner” is a charlatan, woo meister, etc.

  7. Slightly beyond living memory, herbals were used on a regular basis in allopathic medicine, you know, real medicine.
    I had noticed an interesting effect with one tea, when I had just became hypertensive. It was a chance discovery, as I tend to keep a tea cabinet full of all manner of teas, including herbal teas. They’re retained not as medical teas, but as a beverage.
    Ginseng tea works for me on those mornings I’m a bit muzzy. Muzzy past the usual ability for coffee to jump start my day. As I drink a lot of coffee, I have a tolerance to coffee anyway. But, it works for me on those rare days.
    Chamomile worked for my blood pressure in the early days of my hypertension, for four hours. Was a good stop gap until the pharmacy opened after I forgot to refill and ran out. Tastes good too, which is why I have it.
    Artichoke tea is nice, it gives me a wonderful cup of artichoke tea. 😉

    Many medicines were derived from herbal medicine. Belladonna, foxglove, jimson weed all gave atropine and scopolamine, digitalis and atropine, respectively, at highly variable doses.
    I’ll stick with the precise dosing, thank you. That’s especially true with digitalis, as really bad things© happen with poorly controlled digitalis dosing. Things like that dead thing, which rather upsets people.
    BTW, the chamomile tea bit was observed by our old PA, who discussed it at the University of Pennsylvania, where a study began. No clue how it turned out, but a four hour efficacy and use in only mild hypertension would likely back burner it as a drug, while there are many far more effective drugs.
    I mean really, I could try using jimson weed to treat nerve agent poisoning, but injectable atropine and Pralidoxime hydrochloride comes in easy dose autoinjector pens, phials and vials. As atropine gives initial treatment and the Pralidoximine unbinds the receptor, I’ll stick with the drugs, rather than an herb that has to be given orally and no alternative to unbind the acetylcholine receptors.
    Otherwise, see that dead thing.

  8. Not always. My endocrinologist promised effective remediation of hyperthyroidism if I take methimazole for a year. That said, she said that it would be effective at controlling the current illness and would *probably* resolve the hyperthyroid after a year.
    As we’re speaking of glands without plumbing, it’s outside of my experience base, so I’ll take her word for it.

  9. Heh. I got diagnosed with Hashimoto’s 4.5 years ago. Took 3 doctors telling me I was just lazy and fat before I found one that was like, HEY, let’s do tests! My TPO antibodies were 3500. After four years of treatment and the removal of a 3cm tumor on the right lobe of my thyroid (which I pointed out and was told was normal by one doctor..)my antibodies are around 100 last time I checked. I’ve seen so much woo regarding Hashimoto’s, go paleo, avoid gluten, take this supplement.. the thing that works is taking thyroid medication so that your body stops attacking your thyroid. But, my meds do go up and down. It’s very annoying. However, when I got no answers from one medical doctor, I didn’t go to a crystal healer or shaman, I found another doctor. I hope things work out for you and your, what it sounds like is Grave’s disease? It’s the other side of the coin from mine.

  10. Yeah, it’s Grave’s disease and it’s responding extremely well to methimazole, which my endocrinologist has recently reduced the dosage of.
    My primary has gone with watchful waiting on the aortic dilation, as my aorta has enlarged in one section in my abdomen by 2.2 cm.

  11. I work in a private owned vitamin shop, that is very successful given that the first thing people do is go to the doctor. Some weeks we make 12k, 4k on a random Friday a little while ago. People discount herbal medicine because their aren’t many trials on some of the basic herbs. We legally can’t say cure, I believe in 50/50 give and take with modern and herbal remedies. Myself I am on psychiatric medicine that saved my life, I don’t believe that herbal remedies are a cure all, I don’t think many pharma drugs are either. I think their is a balance to both, but that’s just me. 70% of our customers Coke to us when they feel like they were failed by the medical field,I’ve heard amazing things when it comes to herbal medicine. But, I’ve also seen pharma drugs save someone’s life. We have been open for 30 some years , so that says something. I believe in honesty, I don’t sell products I don’t believe in. I will tell someone to go to the doctor, or I’m like hey, I’m on medicine as well and I don’t necessarily like it but it’s what I had to do.

  12. I’m sorry for the spelling and grammar mistakes my phone screen is shattered and some areas I can’t see some letters.

  13. Quite a few modern drugs are derived from herbal medicines, such as digitalis, the primary difference being controlled dosing.
    Precisely how much digoxin is present present in that foxglove plant? As digoxin is an important cardiac drug and higher dosing than is desired can be fatal, purified, measured standard dosage can be found in the modern pharmaceutical drug, without various crop issues causing underdosage or overdosage.
    Other drugs are derived from the plant sources, to become more potent, have lower side effects or even become new treatments for other maladies.
    Aspirin came from salicylic acid, which was the active ingredient in willow bark extract. Adding an acetyl to the molecule lowered the stomach ulcer rate tremendously.
    Many statins come from various molds, discovered for various salutary effects, while avoiding some of the toxic effects also present in the whole mold secretions. The same is true of multiple antibiotics.

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