No Progressives In Hospitals

I have so frequently experienced resistance to evidence-based complementary and alternative medicine (eCAM – there is even a medical journal for it) from otherwise intelligent open-minded people that I decided to put down my thoughts about this life-altering subject.

The title of this piece was inspired by the saying, “There are no atheists in foxholes.”  The reference is to the belief that even people who claim to have no particular faith seem to find some in a hurry when they believe their life is in peril.  By the same token, it seems to me that the vast majority of people I have encountered – and I’ve talked to an awful lot of them over the years – will not give serious consideration to eCAM once they experience a serious health challenge, especially if it is serious enough that they find themselves hospitalized.

And while this thinking is not surprising coming from those whose views are generally conservative, I have been repeatedly confounded and astonished at how many otherwise intelligent open-minded people act the same way, hence the title of this piece.  It seems that once someone has felt the fear of their own mortality, their reasoning ability, analytical skills and even skepticism just seem to evaporate.  Truly astonishing.  And heartbreaking.

I am fairly progressive-minded, politically and otherwise, and have a lot of friends and even a few family members who are as well.  (While I’m proud of my beliefs, I only bring it up here to make the points that I know and have met many people of a similar mindset, and I have something of a reputation for being progressive-minded, so it seldom surprises people when they hear progressive thinking like eCAM come out of my mouth.  It may even enhance my credibility to a degree.  I don’t know.  Also, I should add that it is certainly not necessary to be progressive-minded to embrace eCAM.  Heck, some embrace it because they are conservative and skeptical of conventional or allopathic medicine, as well they should be, given the very spotty record of conventional medicine.

So, understandably, I would try to help those I love and care about, just as I do those I only know professionally.  That makes it all the more frustrating when these people I know well seem to lose their damn minds when good old fear comes into play.  That is the only explanation I can come to.  I give them good information and, to the extent possible, evidence of its efficacy, either from studies or in anecdotal form.  And, while not all may entirely trust me, I believe most of them do.

I suppose a lot of people reading this will think, “You’re being naive to not think fear clouds judgment.”  Yes, of course I realize that.  But, I never cease to be amazed at the degree to which that is true.  What a powerful and addictive drug fear is!  Think about it.  Just as we know to be true of addictive substances, fear turns people into someone hardly recognizable to those who know them, calling into question their reasoning ability and emotional stability.

I also realize that Big Medicine, or the Medical-Industrial Complex, as some refer to it, has SO much money, and so many forms of propoganda – ubiquitous ads, impressive buildings, authoritative people, big well-funded foundations – that it’s damn hard for eCAM to compete.  But there is SO much evidence to undercut the credibility of these representatives of conventional medicine.  And so many downsides that (most) everyone is aware of, even before I start to point them out.  These include:

  • drug side effects
  • infection rates in hospitals
  • the high cost of conventional medicine and medical insurance
  • the low effectiveness of drugs and many medical procedures

Just listening to a drug ad on TV and hearing all the side effects – that they quickly race through as you’re watching images of happy, healthy people – you would think would be enough to turn anyone off to ever taking pills!  But it doesn’t.  We are the most addicted and prescribed-to population of people in history.

And with all that money comes the ability to fund very long and expensive studies required to get drugs tested and approved.  That kind of funding is almost non-existent for EBCAM.  Part of that is because so many of the products and methods that make up eCAM cost much less, and many may not even be eligible for patents.  For instance, EFT (Emotional Freedom Technique), a simple tool proven effective for relieving stress is free.  (Sure, you can pay a practitioner to teach you EFT, but you can find everything you need to know about it on the Internet, written in plain English, that anyone can learn apply in a matter of minutes.)  That’s why you will never see the ads or randomized, double-blind, placebo-controlled, peer-reviewed studies for EFT that you will for prescription tranquilizers and pain-killers like Valium or oxycontin.  But the flip side is you will never hear of anyone becoming addicted to, much less dying of an overdose from, EFT.  And that’s just one example among thousands.

So many tools and therapies of eCAM strain credulity with their low cost and simplicity.  “If it’s so cheap and easy, why isn’t everybody using it,” is the argument you hear (or can be pretty sure they’re thinking).  But once again, I would like to think people would reason through the pros and cons of trying an alternative.   If they would just take the time to do that, likely they would at least give themselves pause before simply taking the conventional medicine approach.

And yet the power of reason is often clouded by emotions, not just fear but also trust.  Even people who are – or at least consider themselves – smart or skeptical are often no match for the persuasive power of people in nice offices with white coats, stethoscopes around their necks, diplomas on their walls, and titles like ‘doctor’ and lots of cryptic initials after their names.

As an illustration, let’s say you are suffering from considerable back pain.  You can go to a chiropractor, try yoga or EFT, just to name three eCAM choices you have.  They range from inexpensive to free and most can be tried out quickly with little if any risk of side effects.  Or you can get a doctor’s appointment (with an MD).  That may result in just being told to talk two aspirin and call back the next day, or it might result in a referral to a specialist, a recommendation for surgery, and/or a prescription for a pain-killer that carries with it a substantial cost (which someone has to pay, even if you do so through insurance, if you have it – and it’s covered), potential side effects including addiction, injury or even death.

This is just one example, but you can use this as a template to set up plenty of other comparisons to weigh pros and cons.  eCAM won’t come out on top every time, but often it will.  Mostly where conventional medicine comes out on top is with trauma care.  When acute, often life-saving measures are needed, that’s their strength, and there are few alternatives.

eCAM often compares favorably to conventional medicine not just because the cost and side effects are far less than that for conventional medicine, but also because the outcome is often as good or better.  The placebo effect is often talked about, especially when people are referring to eCAM, and especially if they are skeptical about its effectiveness.  They may say something to the effect of, “well, if it works at all, it’s only because people expect it to or want it to.”  Okay, that’s still a positive outcome – without the risks and costs a conventional approach may involve.

And on the topic of outcomes and the placebo effect, have you ever read a medication package insert that comes with (or at least is available for) all drugs, prescription or otherwise?  The section on Clinical Studies covers the effectiveness of that drug.  By law, they must state the clinical outcome of controlled testing for how well the drug works when used as directed.  They do not make it easy to understand this information.  In fact, there have been pleas from many parties to simplify the contents of this important document so users can comprehend the information in order to make more informed decisions about their health.  Skeptics have made the argument that the pharmaceutical industry has so far resisted attempts at simplification for fear their customers will finally realize ‘the emperor has no clothes’, that is, that these drugs are far less effective than their slick, simplistic ads suggest.

I have searched for, but have so far been unable to find, a meta-analysis that I read years ago on drug efficacy.  (A meta-analysis is a study of studies.  Many studies on a subject are reviewed.  Then their data is compiled and overall trends and patterns discovered are put into a report.)  This particular meta-analysis reviewed how effective the manufacturers of pharmaceuticals reported their drugs to be for their intended purposes.  The overall figure I recall was 26%.  Yes, the average efficacy of all drugs they included – and as I recall it was very broad and extensive – found that their stuff worked on only about 1 in 4 patients.

And those are the best numbers the manufacturers were able to come up with, even after many documented cases of bias in the research used in these studies and using every tactic imaginable to skew the results in their favor, things like throwing out and even hiding data that did not conform to their desired outcome.

I also filed away in my brain another useful figure that I wish I could find again.  It was the effective rate of the placebo effect for all drugs.  Again, you’re going to have to trust me (unless you can find the data I have been unable to find recently, and if you do, please share it with me).  That figure was 30%, the placebo effect for all drugs.  So, if my memory is correct, that means that the placebo effect works better than drugs!

The point of including this information in this post is that – again, if my facts are correct, or even close – it should shake people’s confidence in the ‘hard science’ of conventional medicine.  At the end of the day, the zillions of dollars and manhours and the many decades spent on research and testing produces products that are no more effective than the power of belief.  Or it can be turned around: the power of belief is every bit as effective as conventional drugs.  Does that rock your world?

So, if you have read this far, we can conclude two things.  One is, you either found this post by accident – and there are no accidents – or I referred you to this in the belief I could appeal to your power to reason (over the emotional pull of fear).  The other is that you found my words and thoughts worth considering.  I sincerely hope this helps you by injecting some reason into these difficult matters, and you make the best decisions for the well-being of yourself and those you love.

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