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01/12/2011 / Pedanto

Education Misinformation

As we sit in a lecture theatre after a morning of palliative care (teaching not treatment) the lecture I’ve been waiting for has finally arrived. I’ve been building up my bile stores for days. I’m ready to kick some arse. Finally some teaching on complementary and alternative medicine.

When I last had teaching on CAM I was uniformed about it. The only thing I would have been able to do would be to cry “BULLSHIT!!”. I hardly knew anything about CAM. James Randi, Edzard Ersnt, Ben Goldacre, Simon Singh, Mark Crislip, Brain Dunning, the SGU rogues and the podcasting members of the Merseyside Skeptics Society; all these were complete unknowns to me. My inner skeptic was barely embryonic by this point. I simply sat there impotent and unable to debate. How does one cry bullshit without the evidence? Of course just drawing on an understanding of science helps, however without evidence I could never have combated the special pleading and magical thinking that CAM promoters put forward. Simply to have denied someone’s claims without any evidence to refute them would have made me look like a tosser. Go figure!

Nemesis

But here I am on the first of December 2011 ready to take this bitch down. I was hoping for a Lex Luthor to walk through the door, instead I’m presented with someone’s grandma.

Bollocks!

Surely I can’t be a cruel bastard to this harmless looking dear. Hell, she works for Marie Curie Cancer Care, a charity which seems pretty pleasant really.

Then out come these words: “Hello I’m **** **** from Marie Curie Cancer Care. I’m a registered nurse and a certified reiki practitioner”.

Fuck this bitch.

My Fellows

I am very aware that I probably have an unusually high level of understanding of what complementary medicine entails amongst medical students. I don’t say this to sound superior, but it is true. Generally we as a profession are aware that most CAM is abject bullshit, however not many of us have put aside the time to find out about it in more detail. Perhaps the fact that I have points to some kind of underlying personality disorder….

Sure baby I can prescribe whatever I like!

Anyway back to my point. We generally don’t know much about CAM and this lecture was meant to be educational. So what was covered?

Massage

I have no problems with massage. It seems nice and helps with palliation. All in all it’s good. Claiming it’s 3,000 years old as our lecturer did riled me a little as there was no back up for this claim. But hell I’m an easy going kind of guy, and she only had 15 minutes so I’ll let that one pass.

Aromatherapy

We got hit straight between the eyes with an implied naturalistic fallacy (it’s from plants which is in some way good). There wasn’t really much more content to this section apart from the warning us that some of the oils can be “very strong”. I not long ago ingested some naturally occuring by-products of fungal metabolism and because they were “very strong” I felt a little peaky and had to empty my guts neatly in an Armitage Shanks sanitation device. Just to be clear “very strong” seems to be a synonym for toxic. Here’s your resource for further reading (there will be a test).

Reflexology

Now we’ve hit woo town! So my foot is a homunculous of my body apparently. Oh and it dates back to ancient Egypt does it? Now they were known for their amazing scientific advances in healthcare – their hook based neurosurgery never seemed to take off though. Fortunately we did have a walking talking data point telling us she could feel each individual organ as it was being stimulated by the reflexologist. That’s the word I’m looking for right? Right?

Oh shit I remember!

DATA = PLURAL

DATUM = SINGULAR

ANECDOTE = AN EFFECTIVE WAY OF CONVEYING A LIE

Finally she revealed that she’d never stayed awake through an entire session of reflexology – perhaps indicating if nothing else it may be good for insomnia.

Reiki

Magically waving your hands over someone’s body. Right, that’s useful. Apparently the patients she treats have many reactions to this, many of which sounded like hallucinations. Now I’d never accuse a well meaning hippy of doping someone. But if I were a well meaning hippy I would definitely dope someone. Just to reinforce, I’d never accuse a well meaning hippy of doping someone. But if I were a well meaning hippy…..

Acupuncture

Meridians and all that stuff. Here’s a quick explanation about Qi and Meridians: a long long time ago in China autopsies weren’t allowed. Therefore anatomy had to be invented. Some very fanciful people made up magic life force and channels they pass through. Then like my toilet after a kebab, that shit stuck.

Apparently sterile needles are used – I personally wouldn’t trust the autoclave of someone who thinks that shoving pins into you will help anything.

Hypnotherapy

By this point I had burst 3 of my berry aneurysms, but I’m a trooper so I kept listening. Fortunately this was all fine – balancing mind, body and spirits using pieces of something I think. All fairly nebulous crap. There was a mention of using it to treat PTSD – not very happy with that idea myself as I can’t find any evidence to support it’s use apart from the very occasional case study.

Health and Safety

We then got a little talk on the safety protocols that are in place to protect patients these included:

  1. An information leaflet about therapies which I’m sure will both make the general public scientifically literate and give them fantastic critical faculties.
  2. Written consent is required – usually only done for unwise decisions such a allowing a surgeon to cut you open or someone to stick needles in you.
  3. Therapists are all certified by a respectable organisation. And I’m sure the fact that I have a bit of paper saying I can perform a wedding in America really does give me that power. Plus I’m a nutritionist don’t you know!
  4. They maintain confidentiality – woop de fucking doo! I hope this doesn’t catch on with other health professionals.

Evidence

Finally we got a little insight into some special pleading. She began by saying that research was difficult, as taking the therapist out of the equation would bias it in some way. Well that’s what we in the biz (nutritionists like me) call a “lie”. There’s plenty of research out there, both good and bad, positive and negative. Strangely the negative stuff seems to be the good and the positive stuff seems to be the bad. How odd.

Where’s My Beef?

So what’s my point? I’m sure none of my colleagues were taken in by the magic we were told about (though people should get into magic more. It’s really cool!!!).

Shortly after the lecture, in the canteen I had to give a little teaching session of my own. Some people saw no harm in CAM as they had only seen helpful masseuses in hospices and hadn’t encountered the likes of Jim Humble or Mathias Rath.

Some people felt that more research needed to be done and that no funding was available for this –  a simple lack of knowledge is on show here that a quick look on PubMed would solve quickly. There’s a lot of evidence out there, it’s just the people who promote CAM wish to ignore the evidence which puts it in a bad light. And once you’ve cherry picked away all the evidence disagreeing with magic you are obviously left without much, and it’s understandable to want more research on this area because there’s so little!

I don’t have a problem with CAM in end of life care. Why not have a massage? It could be very nice. I fondly remember my own grandad receiving some fantastic complementary therapy in a hospice in the form of some Guinness my Dad bought in – it wasn’t medicine, I’m fairly certain there’s no evidence for it, but it cheered him up.

So here’s my message: CAM teaching at medical school in the UK is poor. Very poor. It allows a believer a platform to drool out their nonsense. Without any input from a scientist or your friendly neighbourhood skeptic. If tomorrow’s doctors are expected to deal with patients’ health beliefs and preferences, an awareness of what they actually entail might be useful. Even more importantly we are scientists first and foremost, and allowing some of us to walk out of a science degree believing in health based fairy tales is irresponsible.

Thanks for reading.

Here’s your funnies:

Not quite as skeptical as usual but it’s probably worth relaxing sometimes.

Housekeeping:

  1. Sorry for the unusual amount of swears this post. It’s been a while since I last wrote and for some reason the ability to articulate myself without being crude has disappeared. I will try to be more genteel next time.
  2. If you go to a medical school beyond Newcastle (surely you can’t survive in such warmth all year round!) I’d be very interested in hearing if your CAM teaching has been any better.
  3. Don’t be a twat.
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