Traditional Medicine, Scientific Method, and Healthy Skepticism
First of all, my apologies for putting a bad word into my title: skeptic/skepticism/skeptical. It seems all the variations of that word have become “dirty” lately, or at least have negative connotations associated with them, particularly in the new-age-ish set. In a bit, I will return to this and explain my defense of skepticism and why I think skepticism (not pessimism) is a healthy and needed part of self-preservation and adult life.
Recently a friend posted a satirical video of “gluten sensitivity” and the gluten free lifestyle, as practiced by those with no official diagnosis of celiac or gluten intolerance. The video poked fun of a variety of aspects of the topic, including how freely people with no diagnoses dispense strident and dogmatic advice to others who DO have a diagnoses. Usually this advice is directed to people who have a diagnosed condition of an unrelated nature to celiac, insisting that gluten is the cause of whatever disease the person has, and of course, eliminating gluten will “cure” that person’s ailment.
In response to the post, I replied that I myself had been on the receiving end of a whole lot of totally unsolicited advice that stated that completely eliminating gluten would cure my autoimmune disorder (which causes, and I personally have suffered from, among other things: severe joint degeneration including fusion of the spine, shoulders, and hips; nerve pain; hypothyroidism; kidney disease; and digestive disorders- which I have had painful surgery for).
I explained that I had been tested for celiac at a research focused university hospital by both immunologists/allergists, and my rheumatologist, and that I am not in any way gluten sensitive. I laughed that when I tell gluten free enthusiasts this, they insist that whatever tests my doctors gave me weren’t good enough, that a naturopath/homeopath/osteopath would have a better, more effective one.
Since I have a lot of friends who practice eastern medicine, ayurveda, naturopathic treatments, etc… I want to explain a bit about why I can sometimes get so frustrated with (generally) well intentioned advice like what I describe above. I don’t have anything inherently against non-western modalities of medicine, at all. I really don’t want to offend anyone, and I am fully in support of anyone who is seeking to heal themselves or to feel better.
First, caring for myself and advocating for myself is a never-ending, full time battle. It NEVER feels like what I do is good enough. It’s never good enough for my doctors, never good enough for my work, never good enough for anyone, including me- since I still largely still suffer from chronic pain. I have spent untold hours seeing and driving to doctors/specialists, sitting in waiting rooms, recovering from surgeries, researching recommended medicines, trying diets, therapies, exercises, etc. Throughout, there is always someone who is dissatisfied with a choice I have made (for example: my immunologist because I won’t take daily nasal sprays/pills for sinusitis- because those meds may interfere with the battery of meds I take for my other, more painful and dangerous health concerns; instead, I choose to use a neti pot).
There is a persistent sense that my condition(s) are a burden on others: on my doctors because treating incurable conditions is pretty thankless, on my friends if I talk too much about what is going on, on my company since I am the costly one to insure, on my family because they usually have to take care of me during my hospitalizations… Believe me when I say I try very hard to take good care of myself. I am, obviously, invested in being healthy- not just because being in pain completely sucks and no one wants to be disabled (I cannot tell you how awful it feels when I have to use my cane or my handicap tag), but because me being healthy eases the burden on those I care about, too.
So when someone who largely knows nothing about my particular condition or what I have and have not tried to treat it, comes along and simplifies things down to: well if you’d eliminate gluten you’d be cured… it’s like a slap in the face. When I put aside my emotional reaction to what they are saying (which feels like: your disease is all your fault because you choose to eat gluten), I try very hard to explain that I have a process that I use to evaluate potential treatments. That process leans heavily to relying on scientific methods – one of the few things I have some trust in, these days.
Let me return to the word, skeptic, for a second. I am a proud skeptic. I am also an idealist, and I don’t think the things are mutually exclusive (but that’s a whole other blog post). I have a very healthy skepticism for all human systems and being a skeptic has kept me safe and alive numerous times. So if I seem harsh about alternative medicines, know that I am just as skeptical of western, traditional doctors. God knows I have had some pretty terrible and dangerous experiences with regular doctors. However, I DO put my trust in scientific method, which includes (I simplify a lot) presenting a theory, then setting about supporting that theory in a way that is repeatable, measurable, reviewed by peers, etc…
I am not inherently against naturopathic medicine; what I am opposed to is putting my life into the hands of a treatment that isn’t supported by science. I am not advocating that pills are more effective than diets, I am saying that when there is proof, supported by science, then I will willingly try that treatment. I may try one that isn’t, provided the risk is low, and it is convenient and cost-effective. I am highly skeptical of ANY doctor’s desire to spin scientific evidence for their own means- western doc or not. When I evaluate a potential treatment, my thought process goes something like this:
|Treatment Name||Treatment Purpose||Cost||Convenience||Availability of Scientific literature in support of treatment||Potential Benefit of Treatment||Potential Harm / Risk of treatment||Western Medicine Thoughts on Treatment||Decision|
|TENS Unit||Alleviate muscle spasms in neck||Minimal||Very Convenient||Moderate amount of studies available; conclusions unclear||Low: Short-term improvement of spasms||Miniscule: no known injuries from treatment||Accepted with caveats||YES|
|Neti Pot||Alleviate sinusitis symptoms||Minimal||Convenient||Limited||Moderate improvement||Minimal: use distilled water and sterilized equipment||Accepted with caveats||YES|
|Humira||Reduce systemic autoimmune flare frequency||High||Moderate: painful shots, shipping is difficult||Abundant||Potential for vast reduction of systemic symptoms; won’t reduce symptoms from already existing joint damage||High: known to cause cancer, severe infections, etc…||Accepted||YES- trial basis|
|Gluten-free||Reduce autoimmune symptoms||High||Very inconvenient- particularly with my work travel||Minimal for my condition; non-existent for peer-reviewed, published studies||Moderate: won’t reduce symptoms from already existing joint damage; may reduce additional inflammation of joints||High: nutritional deficiencies are likely (I am already anemic and am treated for other mineral deficiencies)||Not accepted||NO- limited tests I’ve already tried don’t indicate this will work|
As you may see from my unscientific (lol) chart, I am accepting of treatments that traditionally fall in the realm of naturopathic medicine- provided that there is enough literature (even if it isn’t peer-reviewed double-blind studies, which are typically required in medicine), and the potential harm/benefit matches the convenience/cost.
One other thing I will add is that my final litmus test for anything that involves putting my life at risk is this: if you had a medical emergency, who do you call? In the US, at least, you generally will call a western doctor or go to a western hospital. When I had my arterial dissection and stokes, and needed surgery, no one was like: hey you know what, you should really see a naturopath first, before that surgery! It was an emergency, and I needed brain surgery. We put our trust in surgeons who operated with the best available scientific information (information gleaned by studies that use sound scientific methods). It wasn’t perfect, and certainly there were challenges with the doctors, but I was far more comfortable with people who at least tried to use treatments advised by knowledge gained from peer-reviewed literature. I am always skeptical of people and systems, but I am more trusting of a system/method that freely will admit when it’s wrong, and will look for and seek out errors; one that wants to find evidence in support of its assertions (not prove “truths”): the scientific method.
Finally- there seems to be a lot of cognitive dissonance in folks around science. In one conversation I may hear friends bemoan climate-change deniers, taking them to task for ignoring science and denying the efficacy of scientific methods; then these same people are willing to throw science out the window when it comes to things like vaccines, GMOs, and medicine. It’s just… weird. It’s illogical and hypocritical, and I don’t like it.
In conclusion, if you want to talk to a sick person about being gluten free, my advice would be to approach it something like this (if you must approach the topic at all, and actually – please just don’t if your advice is unsolicited): there are some studies that, while not peer reviewed or double-blind supported, indicate that gluten free diets in non-gluten sensitive people MAY reduce some symptoms of inflammation associated with some autoimmune conditions. Do NOT use the word “cure” and do not assume that you know anything about whatever condition the person has, and what treatments they may have tried, unless they have explicitly told you these things.