Exploring the Alternative

This is a guest post from Ian Cromwell. See his full bio at the end of the article.

 

I live in Vancouver. Vancouver is home to quite a bit of what is wildly-inaccurately called “alternative medicine”. What people think they mean by this term is medical treatments that fall outside of the conventional combination of surgery, pharmaceuticals, and other forms of medicine that one expects to find in a hospital. Some even fancy these treatments as operating in a different medical paradigm – an entirely new way of looking at the human body and human health.

The truth is that “alternative” medicine has been around forever – it’s how we treated illness before we understood anything about immunology, biology, biochemistry, physics… basically it’s what we did while we were all idiots. Apparently some of us are still wedded to our historical idiocy, and are promoting this prescientific bafflegab under the label of “alternative”. However, there’s nothing alternative about it – it’s just the stuff that doesn’t qualify as real medicine.

People here in North America don’t seem to appreciate this line of reasoning. They accuse people who recognize the importance of basing our health care decisions on scientific evidence of being “closed-minded” and “reductionist”. This is an inaccurate characterization, since the whole principle of the scientific method requires open-mindedness and evaluation of truth based solely on observed phenomena. However, cloaked in a certainty borne of smug arrogance (“science doesn’t know everything – there are other ways to know things”), people readily flock to nonsense ‘treatments’ like reiki, homeopathy, acupuncture, reflexology, and a whole host of others.

However, there are millions of people who turn to these ‘alternative’ therapies because they can’t get actual medicine:

Ignoring the red-and-white danger sign, Sri Mulyati walks slowly to the train tracks outside Indonesia’s bustling capital, lies down and stretches her body across the rails to seek electric therapy. Like the nearly dozen others lined up along the track, the 50-year-old diabetes patient has all but given up on doctors and can’t afford the expensive medicines they prescribe. In her mind, it is only option left. “I’ll keep doing this until I’m completely cured,” said Mulyati, twitching visibly as an oncoming passenger train sends an extra rush of current racing through her body.

Side effects may include headaches, nausea, cramps, and being crushed by a $%#!* train. It is sad to see that a complete lack of a social safety net has resulted in conditions being this bad (are you paying attention Americans? Republican North Party?). It’s stuff like this that lights the fire under me to keep defending a well-run and publicly-funded health care system.

Back to my original point though. I challenge anyone who promotes ‘alternative medicines’ to explain why this particular therapy is stupid, but your treatment of choice isn’t. For those promoting science-based medicine, this task is easy: rigorous examination of patients reveals that those that lie on train tracks to cure their diabetes experience the same rate of cure as those that pursue homeopathy, reiki, crystals, ‘distance healing’, and whatever other nonsense term you’d like to throw out there.

If you’re not of a mind to call this therapy stupid and think that there’s something to it, then I really have to question your sanity. These are people risking their lives for a cure that not only doesn’t work, but can’t possibly work. Diabetes is not a condition of the nervous system. Electrical shocks would have no effect on the ability of the pancreas to produce its own insulin. The only thing that repeated and prolonged shocks might do is the same kind of effect you see in electroconvulsive therapy – massive release of endorphins and neurotransmitters, causing temporary feelings of euphoria. It would certainly explain the types of testimonials available in the article:

But Mulyati insists it provides more relief for her symptoms — high-blood pressure, sleeplessness and high cholesterol — than any doctor has since she was first diagnosed with diabetes 13 years ago.

Illness is a complex and multifaceted concept. I am entirely willing (and so is the medical community) to grant that there is a psychological role to all disease. This doesn’t mean anything quite so Chopra-riffic as being able to think yourself well from cancer, but it does suggest that management of any kind of illness requires an understanding of patient psychology. Anyone who can tap into a patient psychologically can provide “relief” of a certain kind, but that doesn’t do anything to treat the underlying biophysical problem.

Then again, some problems are not exactly biophysical:

The Philippine government has warned against using geckos to treat various diseases, including Aids and cancer, saying the traditional and common practice across southeast Asia could put the ill at greater risk. A Philippine health department statement said on Friday that the use of geckos as treatments had no scientific basis and could be dangerous because patients might not seek proper treatment for their diseases. “This is likely to aggravate their overall health and put them at greater risk,” it said. Treatments for asthma are easily available and affordable, while there are antiviral drugs to control the progress of HIV, the statement added.

Sometimes the problems are more deeply entrenched than even an adequately-funded health care system can address. Proponents of ‘alternative medicine’ often point to the age and popularity of their nonsense as evidence that it must work. After all, the reasoning goes, why would people stick with something that doesn’t make you better? Surely people are inherently rational and will abandon bogus medical intervention once they have been shown not to work. As difficult a time as alt-med types have with evidence, it seems to point in the opposite direction of this hypothesis.

And sure enough, just like in the Phillippines, there are always those who are hovering around the crowd of desperate sick people, circling like vultures and waiting for an opportunity to make a quick buck. The problem is that there will always be hucksters and charlatans who are more interested in making money than making people feel better. Worse, there are those that honestly believe they are helping, but who don’t bother to follow up or investigate their ‘patients’ longer than it takes to pocket their fee and hear a testimonial.

This is a problem that can be addressed only in part by legislation – we can’t really legislate people into rationality. It is for this reason that I am a partisan skeptic: we need to be actively promoting the ideals of basing our decision-making on scientific evidence, rather than simply saying “well people are going to do what they want.” This kind of arch-liberal hands-off cowardice is laying out the path for more abuse, fraud, and ultimately preventable deaths.

Ian Cromwell was born in Vancouver, and has spent half his life living in Ontario. Ian’s academic background is in health care and epidemiology, with a master’s degree in epidemiology from Queen’s University in Kingston, Ontario.

Currently living and working in Vancouver, Ian spends his off-work time volunteering with the Centre for Inquiry and as a member of the Vancouver Secular Party. Additionally, Ian is a musician and blogger, and has been known to bust a dance move on an occasional basis. Follow Ian at The Crommunist Manifesto or on Twitter.

 

2 Responses to “Exploring the Alternative”

  1. Are you arguing that public health care reduces people’s usage of alternative medicine? If we look at the US, is alternative medicine more popular there? Is it more popular amongst the medically uninsured?

    Anecdotally, it seems that in western countries alternative medicine seems the most popular with people that can afford medicine. But I’d be interested in seeing the stats on this.

    • Crommunist says:

      I think your comment confuses two different issues, Jonathan. People who use alt-med are definitely among the more well-off in North America, but that relationship is muddied by the availability of health care to the majority of people (even in the USA). Above a certain ceiling of financial security yes, alt-med is a rich person’s pursuit. However, it is rare to see (even among the wealthy) alt-med used as primary care for acute illnesses except by those that legitimately cannot access any health care whatsoever.

      The article about the track therapy specifically states that people are pursuing this type of ‘treatment’ because they cannot afford private hospitals and medication. If they could (under a publicly-funded system), they could get actual medicine. It was that issue – lack of real health care due to inability to pay – that I was referencing when I made my defense of public funding.

      I think it would be extremely interesting to look at patterns of alt-med use wrt wealth. However, it would be important to control for cultural factors. Many cultures that use alt-med for traditional reasons also live in comparative poverty – I am thinking specifically of First Nations groups and Latin@s in the USA.

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  • Scott Gavura

    Scott is passionate about improving the way drugs are used. A pharmacist by background, Scott has a professional interest in improving the cost-effective use of drugs at the population level, while helping consumers make more informed decisions about their health. He blogs about pharmacy practice and questionable science at Science-Based Pharmacy and Science-Based Medicine. All views expressed by Scott are his personal views alone, and do not represent the opinions of any current or former employers, or any organizations or associations that he may be affiliated with. All information is provided for discussion purposes only, and should not be used as a replacement for consultation with a licensed and accredited health professional.