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Fri Jun 12 22:00:44 BST 2009

The things I have seen that 'cannot be explained by science' have  
turned out to be explained by the placebo effect, the general  
credulity and pattern-seeking that is inbuilt in homo sapiens, and  
people's need to feel special by decrying experts because their 'mommy  
sense' (a la Jenny McCarthy)or their 'guardian angel' tells them  
something different.

Why, when Dr Mattox et al constantly point out that if you have a new  
treatment modality you must provide the evidence for it, does all this  
other stuff get accepted without question?

I know it's nice to think that there are things out there that we  
haven't investigated or explained yet, but why not keep the sense of  
wonder for things like the Higgs-Boson and the LHC? Or the Hubble deep  
field, which revealed to us just how much more universe there is to  
explore and explain?

Just as in any trial of a new surgery or a new lab test, if the  
results aren't reproducible under controlled conditions by a large  
number of people then the effect doesn't exist.

And no, I place no 'faith' in faith. I'm a doctor and a scientist.  
Much like the pilot who landed the plane in the Hudson without  
praying, when the crap hits the fan I rely on my skills and training.  
Nothing else, ever.

Fiona.

On 13/06/2009, at 1:54 AM, Rick Tappan wrote:

> I guess you don't put much in faith either? Not saying science and  
> medicine
> should not be evidenced based, but in 30 years I have seen things I  
> cannot
> explain and stopped trying. By the way on the rants about Shock- 
> Trauma in
> Baltimore, it is an integral part of the University of Maryland  
> Hospital and
> trains military surgeons in preparation of their work overseas. It  
> also
> trains those individuals from the military who go off and do  
> interesting
> things in far away places. My point being that while not ACS level one
> verified, it still has to meet all JCAHO requirements. Not that  
> JCAHO is the
> end all and be all.
>
> Rick Tappan
> 703 726-3734
> rtappan at gwu.edu
> "Who Dares, Wins"
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org 
> ]
> On Behalf Of Fiona Wallace
> Sent: Friday, June 12, 2009 4:27 AM
> To: Trauma-List [TRAUMA.ORG]
> Subject: Re: Alternative therapies (OT)
>
> Oh, for goodness sake.
>
> The plural of anecdote is not data.
>
> It is well recognised that sticking needles in people has definite
> physiological effects, however it DOESN'T MATTER where you put the
> needles.
>
> There is no such thing as 'life energy' except the stuff that comes
> out of defibrillator paddles (and then only when it works)
>
> My prescription is for a year long course of Pharyngula, Skeptic's
> Guide to the Universe and Quackcast (Google them if you haven't come
> across them). Alternative 'medicine' is no different from any other
> sort in only one respect - it needs an EVIDENCE BASE and sound
> physiological underpinning before it's used in a clinical context.
>
> /rant (but happy to continue the discussion elsewhere)
>
> Fiona Wallace.
>
>
> On 12/06/2009, at 5:32 PM, Lorick Fox, MPAS, PA-C wrote:
>
>>
>> We may want to be slow to totally scoff at some of these therapies.
>> I must admit I generally (still) do, but:
>>
>> About 7 years ago I ended up doing an informal consult on an
>> Egyptian (in
>> Cairo) with marked LV systolic dysfunction who had refused
>> revascularization.  Despite having some really good cardiologists and
>> cardiac surgeons in Egypt, somehow an "American opinion" was valued.
>> I ended
>> up joining his family for dinner one night.
>>
>> At that dinner I met a Japanese practitioner (who spoke no English)
>> who was
>> present because the family had flown him to Egypt from japan to use a
>> "laying on of hands" therapy for a patient with ALS. He specialized
>> in care
>> of neurological disorders and despite the language barrier, with
>> translation, we had an interesting conversation.  I think I still
>> have his
>> business card somewhere.
>> Now, I did NOT see the patient with ALS, nor a medical record to
>> verify the
>> diagnosis.  However, the family was well off (to put it mildly) and
>> the odds
>> are they had high end neurological evaluation.  (The cardiology
>> evaluation
>> of my patient had been first class, the patient just made bad
>> choices.)
>>
>> The remarkable thing was that, after the "treatments" the previous 2
>> days,
>> the family agreed that the patient (who had reportedly not been out
>> of bed
>> without a lot of assistance for > 1 year) got up and walked
>> unassisted. Now
>> I understand placebo effect, but anyone (regardless of dx except
>> perhaps
>> psyc dx) who has not been ambulating for a year suddenly doing so
>> independently is pretty remarkable, regardless of dx.
>>
>> Since that time, I have spoken with MD acupuncturists, Korean and
>> Japanese
>> traditional medicine practitioners (usually with a translator) and
>> anyone
>> else I found with experience and/or knowledge in the area.  I have
>> become
>> fairly convinced that there is far more to acupuncture than sticking
>> needles
>> in the right places.  It appears to me that successful
>> acupuncturists have
>> some ability to manipulate energy (?Chi? for lack of a better term),
>> and the
>> use of a battery connected to the needles just doesn't make up for
>> that
>> lack. This "life energy" what the Japanese practitioner told me he
>> manipulated with his hands.
>>
>> Interestingly, I have also been told that some people are "Chi
>> sinks" - i.e.
>> can soak up a patient's energy and thus they feel worse after tx, not
>> better.  I met one MD who did at least a month in California learning
>> acupuncture, and had almost no positive responses, and some patients
>> felt
>> worse.  He was indeed a competent physician, based on working in  
>> close
>> proximity daily for years. He abandoned the use of acupuncture.
>>
>> It would be really nice to get a better handle on this.  Just
>> because most
>> of us can't sense, much less manipulate, this alleged energy doesn't
>> mean it
>> doesn't exist and can't be of therapeutic value.
>>
>>
>> Lorick Fox, MPAS, PA-C
>> Gianaclis Support Complex
>> +20-3-448-2335 or +20-45-240-9450
>> Fax +20-45-243-1191
>> Mobile +20-18-230-4448
>>
>>
>>
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