Summertime and the living is busy.  Finally we have sun in the Northwest.  While the rest of the country has been melting in heat, this year we have rarely cracked 85.  Global heating has avoided Oregon this year, and I will need some green tomato recipes.  Good weather, work is busy, and it is the last two weeks with my eldest before he is off to Syracuse, so there is little time for writing, so a brief entry this week.

I always wince at the way anything can be called ‘therapy.’ We have music therapy and garden therapy and pet therapy and art therapy.  I do not deny that it is beneficial for people to participate in those activities while in the hospital, although I am never happy to see disease vectors, er, animals in a hospital.   Dinner should be food therapy, reading should be book therapy, and using the internet should be computer therapy.  I guess it is like calling something ‘medical’ grade, and you can bill more for it.

Some ‘therapies’ are a wee bit more odd.  Indonesians are using railroad therapy.  People lie down on electric railroad tracks because “the electricity current from the track could cure various diseases.”  To date no one has been either electrocuted or squashed, but I suppose it is only a matter of time.

Why train tracks?  Why not a tongue in a light socket or other source of electricity?  Evidently rumor has it that “an ethnic Chinese man who was partially paralyzed by a stroke went to the tracks to kill himself, but instead found himself cured.”  Sounds good to me.  It seems as likely as Palmer cracking a neck leading to a cure in deafness as the basis for a therapeutic intervention.

And so others are using train therapy for their hypertension, diabetes, strokes and other medical problems.  Train therapy is evidently a panacea for a variety of diseases and used by those with no other medical options.  Like all alternative therapies, it is effective against numerous diseases, regardless of the underlying pathophysiology. If only antibiotics could cure hypertension, diabetes and stroke in addition to bacteria.

Does train therapy work?  The patients say it does, despite those know it all skeptical MDs who point to a lack of evidence.  And who would gainsay a patient’s response to the therapy?  If a patient says they are better, are they not better?

Medical experts say there is no evidence lying on the rails does any good.
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.

I was worried they would forget to tell both sides of the story.  And just who is expert on the medical effects of lying on electric train lines?  They go on to note that

Pseudo-medical treatments are wildly popular in many parts of Asia — where rumors about those miraculously cured after touching a magic stone or eating dung from sacred cows can attract hundreds, sometimes thousands.

It would be easy to be snotty and superior about the Indonesians and their use of train therapy, but really, is it any different than the West?  They eat dung from sacred cows, we have the bullshit from the NCCAM.  We have reiki and homeopathy and Tong Ren healing, and all the other therapies that are subject of this blog,  all equally nonsensical.  I see little difference between the use of train healing and much of the published literature in the SCAM world.  A series of uncontrolled interventions with soft endpoints.

Indonesians have the same rationale for the use of train therapy: anecdotes. Every homeopathy apologist mentions  that the millions who have used homeopathy with good effect can’t be wrong, and neither can the hundreds who are using train therapy.  I suppose we could say the Indonesians are doing a pragmatic, real world trial.  Who needs the old randomized, placebo controlled nonsense?  Lie on an electric train track and you feel better. ’nuff said.

Are the patients who believe they are getting better experiencing a placebo effect?  Is this an example where patient centered outcomes are more important that doctor centered outcomes?  Maybe we should use train therapy for the treatment of asthma.  Conductors and engineers, like doctors, “often dress up in special uniforms that convey power and authority… (and) They have very expensive machines”  Probably less expensive than sham acupuncture and sham albuterol.

Train therapy fits the criteria noted in the recent NEJM editorial;  it should be sufficient to “simply to show that a treatment yields significant improvement for the patients, has reasonable cost, and has no negative effects over the short or long term. This is, after all, the first tenet of medicine: Do no harm.”  The train track users say they are improved, it is free, and as long as they get up in time, should have no negative effects.  I would avoid TGV tracks, just to be safe.  I expect train therapy to be come incorporated in Integrative Medicine programs everywhere, or at those near light rail.

There was a time when I was inclined to think that the people who participated in SCAMs were either stupid or ignorant.  I have long ago abandoned that idea.  Some people, as evidenced by occasional comments in this blog, are apparently deranged, but not most.  I have realized that while most SCAMs are stupid, the people who use them are not.  It seems to be a universal human characteristic to participate in nonsense of one kind or another, but the nonsense varies by culture and opportunity. ‘We’ detox our colons and avoid vaccines, ‘they’ eat dung and lie on train tracks.  All are human. Or are they?

Most biologic characteristics have variability. Height, strength, intelligence all vary about the infamous bell shaped curve.  I have also wondered about more intangible characteristics: the ability to think rationally or empathy or a sense of humor.  Like jumping or math, some people seem to be better at these tasks than others.  It does not, I hasten to add, make them better people, except for the task at hand.  I wonder if the uber-rational, the skeptics, are mutants, given what appears to be the relative rarity of rational/scientific thought.  And to judge from the vitriolic response towards the scientific/rationally inclined, the rational must be mutants as they are feared and hated by those they were sworn to protect.

I don’t know.  Idle speculation caused by vitamin D deficiency.  I am going to lie in the sun, not on the Max line. I know this will make me feel better, although I doubt it will cure any illness.

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