I do a lot of driving as part of my job.  I am the sole Infectious Disease doctor at three hospitals and I can spend an hour or two a day in the car, depending on traffic.  What prevents me from going crazy sitting in traffic is listening to podcasts and audible books.    I especially like reading (and yes, audio books is reading, pedant) multivolume epics.   Currently I am reading Steven King’s Dark Tower series, which occurs in a universe “where the world has moved on.”  In Mid-world there was once a world with science and beauty and art, but something changed, what I do not know yet (I am only on the third volume; no spoilers in the comments), and the world moved on, leaving behind some artifacts of science and technology, but it appears to be an increasingly primitive world.  Being fantasy, there is, unlike the world I live in, magic as well.

I like that phrase: “the world has moved on.” I have an understanding of the world and medicine, based mostly, but not entirely, on science.  My understanding of the natural world is not complete, but mostly consistent and validated by hundreds of years of research.  My undergraduate degree was in physics, and, like all premeds and medical school students, have an extensive education in chemistry, biology, biochemist, physiology, anatomy, biochemistry, etc.  It all ties together nicely, especially in my specialty , where I have the most knowledge.  I consider infections at many levels, from issues of single molecule changes that may confer antibiotic resistance, up through the patient and their family, and sometimes at the level of the entire planet.  Truly wholistic, not the pseudo-wholism of SCAM.

The sciences gives a mostly coherent understanding of the world.  Mostly coherent. It does give an understanding of the possible, the probable, the improbable and the impossible.  Most of the sciences, unlike parts of medical science,  are not concerned with the impossible.  There is not complementary and alternative physics, or chemistry, or biochemistry, or engineering.  These disciplines compare their ideas against reality, and, if the ideas are found wanting, abandoned.   Perpetual motion is not considered seriously by any academic physicist; if perpetual motion were an alternative medicine it would be offered at a Center by a Harvard Professor of Medicine.

Most scientists outside of medicine are aware of how easy it is to fool themselves and, by extension, others. As Richard Feynman said.

“We’ve learned from experience that the truth will come out. Other experimenters will repeat your experiment and find out whether you were wrong or right. Nature’s phenomena will agree or they’ll disagree with your theory. And, although you may gain some temporary fame and excitement, you will not gain a good reputation as a scientist if you haven’t tried to be very careful in this kind of work. And it’s this type of integrity, this kind of care not to fool yourself, that is missing to a large extent in much of the research in cargo cult science.”

My archetype for scientists fooling themselves, and others, is the story of N-rays, which I have discussed before.

For whatever reason, and I do not pretend to understand why, medical people are occasionally unable to incorporate the simple concept that unless they are very careful, they can be fooled.  The result is complementary and alternative medicine.  It is the place that remains after the world has moved on.

That phase constantly popped into my head as I looked at the Huffington Post sections on Intergratve Medicine. The world of medicine, at least, has moved on and left the Huffington Post behind.  So much on the HuffPo Intergrative medicine site is at odds with reality that I will mention only a few of the more egregious examples of medical nonsense.  HuffPo is giving Natural News a run for their money in the production of fantasy. Most striking was the homeopathic (the facts being seriously deluded; isn’t that an underlying principle of homeopathy?) article by Dana Ulman entitled Homeopathy for Radiation Poisoning.  Water for radiation toxicity.  Seriously.  And not even heavy water, which might catch the extra neutron.  And the reasoning for its use is even more goofy, if possible, than that of oh-so-silly-ococcinum.

“Because one of the basic premises of homeopathic medicine is that small doses of a treatment can help to heal those symptoms that large doses are known to cause, Ludlam suggested to Grubbe that radiation may be a treatment for conditions such as tumors because it also causes them. This incident is but one more example from history in which an insight from a homeopathic perspective has provided an important breakthrough in medical treatment.”

I suppose since smoking causes cancer you should treat lung cancer with cigarettes and since alcohol causes cirrhosis you should treat cirrhosis is with vodka and guns cause acute lead poisoning so maybe we should shoot gunshot victims. That I suppose, would be reasonable conclusions from homeopathic theory derived from metaphor and faulty metaphor that.

What nostrums are recommend for radiation therapy? Cadmium iodatum, Ceanothus, and Cadmium sulphuratum, for which there are no Pubmed references to support treating radiation toxicity, even though the author says they are a well-known remedies for that condition. Not well known to medical science I suppose.  Ah the wisdom of homeopathy, where saying it makes it so.

Then the author suggests

“Calendula (marigold) is a well-known herbal and homeopathic medicine. Highly respected research has found excellent results in using Calendula ointment on people who experienced radiotherapy-induced dermatitis.”

Now why is Calendula a homeopathic medicine? I went to the original reference and it appears from the literature to be a worthwhile agent  for the prevention of radiation term burns. But  I am not so sure I would classify Calendula as a homeopathic preparation. According to the producers site it is “Calendula Fresh Plant 4%” and in the original article it is “is fabricated from a plant of the marigold family, Calendula officinalis. The digest is obtained by incubation at 75°C in petroleum jelly to extract the liposoluble components of the plant.”  The authors  do not use the word homeopathic anywhere in the reference.

Real product came containing real parts of the plant at a measurable concentrations, hardly homeopathic in nature.  Calendula ointment has not been subjected to proving, nor has it been potentiated, as if either are helpful.  It is not a homeopathic preparation  just because a preparation made by a producer of homeopathic nostrums, although that appears to be the reason. It is a new definition of a homeopathic preparation: if it is made by a homoepathic producer it is therefore a homeopathic preparation. By this standard, the effluent of the Boiron toilets would also be considered homeopathic preparations.

When it comes to homeopathy, not only has the world moved on,  rational thought and consistency has moved on.

And there is acupuncture. There is a link to an article entitled As Medical Costs Rise More Americans Turn to Acupuncture. This is an article from AOL linked from the Huffington Post (now owned by AOL). If you want to get the heebie-jeebies take a look at the opening picture on that page. The text says “Practitioners must use needles produced and manufactured according to U.S. Food and Drug Administration standards, which require needles to “be sterile, nontoxic, and labeled for single use by qualified practitioners only.” The needles may be sterile, but what good is a sterile needle used by a bare hand?

Look at the accompanying photograph. That middle finger does not inspire confidence. It is no wonder that acupuncture is associated with outbreaks of hepatitis C, hepatitis B, and MRSA infections. Most the pictures of acupuncture on this website  demonstrate that acupuncturists lack understanding of basic technique. It is hard to infect people with an injection.  Heroin users inject themselves with a rich melange of bacteria every day without getting infections.  It is hard to infect patients in the hospital with blood draws and IV’s.  But if an infection can happen, it will happen. And those fingers, just recently in a nose, or picking a tooth, or scratching a butt, will spread an infection with an acupuncturist’s needle to one unlucky patient. Not only has the world moved on for acupuncture, it took with it an appreciation of germ theory.

The Huffington Post  seems to be immune from advances in understanding of all of so-called intergrative medicines, or even basic anatomy and physiology. They  link to a video entitled The Meridian System in Oriental Medicine. They might have linked to the anatomy of Orcs or the physiology of Dementors, for all the application to reality it represents.   The video is gibberish when compared to nature as we understand it. The world has moved on.

When Huffington Post published absolute nonsense, I have to wonder how good their analysis is on issues like politics, war,  the environment and other important areas. I was always taught to judge a man by the company he keeps. I have the same problem with my local newspaper, the Oregonian, which publishes the occasional nonsense piece in the Living section.  They often get things wrong in Infectious Diseases, the one area I have expertise.  If they are wrong in areas I know,  can I trust their writings on other topics?

When I finish the series, I’ll let you know, metaphorically, what the alt med Dark Tower is.