Nasty E-Mails and Comments!

Rarely do I use profanities in my debates. I’m a firm believer that debate should be utilized as a learning tool, not one to disparage someone personally. However, I received a lovely comment on my blog here from someone who apparently wasn’t content with one of my opinions. That’s completely fine, people will always have conflicting viewpoints and one of the nice things about debate is that you can go back and forth in a respectful way about your opinions. However, when people try to personally insult you as part of their argument, it shows an utter lack of backing to their opinions, and merely reveals that you struck a nerve in them, got them angry, and they can’t defend themselves rationally so they resort to insults. This comment was one such example!

Let the “Eye for an Eye” begin!

“It is interesting how you spend a lot of your time trying to degrade others who have gone into their respective professions (chiropractic, osteopathy, naturopathy etc..) with the expressed intention of helping others, usually because they themselves were helped when allopathic medicine failed to do so. “

Quibble the 1st: My intentions are not to degrade others. My intentions are to provide discourse and information on healthcare practices that are bogus, quackery, and all out devoid of good science in an effort to perhaps strike a chord in those who would otherwise ignore or be oblivious to these goings-on. The 3 professions you have listed are filled with pseudoscience and only serve as a detriment to the public’s understanding of health and biological sciences. I deride these professions not because I have a vendetta, but because I care about patients everywhere and how they are choosing to spend their money or time in the interest of their own health. When these professions decide to cast off their roots of vitalistic nonsense and start to produce real, measurable scientific results, I will be the first to welcome them with open arms into the fold of healing. Until then, no.

Quibble the 2nd: There’s no such thing as “allopathic” medicine. There’s medicine which works and has been proven by science to do so, and there’s everything else. Allopathy was a derogative term for “mainstream” physicians coined by Samuel Hahnemann, the gentleman who invented Homeopathy, a system which disregards basic fundamental sciences on such a huge level, that it is perhaps the worst offender of them all.

I would hope you went into medicine to do the same, and not just for the money. You seem like a little man.

And here we have a lovely ad-hominem attack against me! Bravo! Good to see you can defend your opinions without resorting to insults. Er…wait…

If you’d spend any time reading my website, you’d no doubt see the scads of posts I have  made bemoaning the current medical environment in the United States, and how I am disgusted by my colleagues who are motivated only by money. But then again, that wouldn’t make for a good insult now, would it?

I was drawn to your website because of your reply to an article I read about Sidney Crosby. You state how good the article is, and then in the next line show your ignorance by questioning how it is that chiropractors get “specialties”. Quite bold of you to have such strong opinions without any facts.

Hooray for more reading comprehension! This was inspired by my posting on http://www.sciencebasedmedicine.org/index.php/chiropractic-neurology/ concerning the topic of Chiropractic Neurology, a “specialty” claimed by many Chiropractors across the US. My words on this site were expressed not as a request for this knowledge, but at the sheer-dumbfoundedness I felt in seeing that these unscrupulous individuals claiming to be competent Neurologists after taking 300 HOURS ONLY OF THE TOPIC, WHICH CAN BE DONE ALL ONLINE. By that logic, one elective rotation should fully qualify me in a medical specialty, residency be damned.

Chiropractors do take post graduate courses to get these specialty designations, and you cannot use it in advertising or in any way unless you have earned the designation from one of the accredited colleges. It is regulated, but of course, like in medicine or any other profession, there will be crooks who try to get away with using them without the valid credentials. It takes a couple of years of course work and it does not imply a ‘medical’ specialty, it is a chiropractic specialty.

Years of coursework? Try again: http://www.chirocredit.com/pages/chiro_neurology.php 300 hours is the minimum requirement to sit for their Board exams. That to me, is laughable. An understanding of Neurology as a specialty takes years, and isn’t something one can do sitting at home in the La-Z-Boy  on the laptop or attending Hotel Room Conferences on Sundays.

‘Medicine’ is only one type of healthcare, as is dentistry, optometry etc… Chiropractors do not pretend to be medical doctors, although some lean that way in practice more than others.

Perhaps in legal terms, but from a science perspective, the realms of Dentistry and Optometry are considering in the realm of Medicine. They utilize good, solid science in their practices. Chiropractors do not.

…and many Chiropractors DO pretend to be Medical Doctors. They are trying in many states to get access as Primary Care Providers, a role which they are woefully inadequate in training to perform in. For a good analysis, see: http://www.sciencebasedmedicine.org/index.php/the-dc-as-pcp/

You and your small minded peers seem to think that chiropractic only involves clicking bones, but the profession is much more diverse than that. Chiropractic Neurology encompasses all non-surgical treatment of neurological conditions, in other words, whatever works, whether it be allopathic or chiropractic, and it attempts to fuse these approaches and apply them appropriately, and with evidence to support it.

Another lovely ad-hominem. Thanks! Really shows your ability to debate rationally and intelligently.

The sad thing about Chiropractic Neurology is that not a single one of its practitioners  has yet to actually demonstrate in a scientific fashion that what they do *works*. They rely mostly on patient anecdotes and stories, as well as simple case reports. The lack of research astounds me.

Funny, in the next part you bring up the “Doctor” treating Sidney Crosby as your example. Here’s a quote from him concerning scientific studies of his “treatments”

“We don’t have enough time to publish studies.” (http://sportsillustrated.cnn.com/vault/article/magazine/MAG1190863/2/index.htm)

So what, lets just do a bunch of stuff that has no basis in the lab and hope it works? If I practiced Medicine that way, I wouldn’t get very far. Nor should I. That’s the kind of attitude that harms people.

The reality is, Sidney Crosby is back on the ice (and looking to move to the KHL since the NHL is in shambles), yet I do not hear any of you eating your words about the apparently successful treatment he received. Your apparent quiet is even more disturbing in light of the fact that the nerologists he did see could not, or would not help him.

We aren’t eating our words because this is one anecdote. We have no idea of knowing what got Mr. Crosby back and playing again. Without further studies, we can’t simply conclude that “Hey, this treatment works. Let’s keep doing this.” The Chiros that champion Mr. Crosby’s case are doing themselves such a disservice by not utilizing even the slightest in critical thinking skills. Again, if I practiced Medicine like this, I’d be in deep, deep trouble. You can’t just treat things with methods you make up, without even knowing if their underlying function has a basis in science. That’s just plain wrong.

BTW, isn’t the Antigua medical program a little bit of a joke? Isn’t that where students go that can’t get into medical school in the US? Stones and Glass houses…

Another lovely ad-hominem! Keep ‘em coming!

Since you don’t know me personally, I’ll let you in on a little secret: I never applied to a United States Medical School. I didn’t want to. I went to Antigua for the express purpose of working in an impoverished country where I could simultaneously learn Medical Science as well as provide outreach to the destitute there who cannot afford to see a doctor.  And not that it really matters, but the University I attend is fully accredited in not only the United States, by also by the World Health Organization. I have completed my classroom studies and am slated to be working in a hospital in my home state soon, which I could not have accomplished if my program was in any-way “a joke”.

It might not be Harvard Med, but at least we aren’t being taught nonsensical fairy tales about how the human body works.

And that, my dear friends, brings us to a close! If you’d like to debate or discuss, I’m always happy to! I will respect your opinions fully as long as you respect mine. But show up with idiotic drivel like the above, and I will deconstruct it for the public to see.

Hope you enjoyed

Hard to believe that was two years ago. Time has passed in an odd way, seeming slow yet fast simultaneously, like I’ve been toying with relativity. Now I sit at my desk back in my cozy home in Ohio, trying with full sincerity to reflect on my time spent living on the island of Antigua. When you think about it, two years really isn’t a lot in the grand scheme of things, but the lessons about life I’ve acquired during that period will last me an absolute lifetime.

When I first arrived in Antigua, I was the same nervous little boy I had been for the past several years. Incapable of taking care of myself, used to the status quo, and certainly not educated about the finer points of life (especially living it!). I spent those first few weeks in seclusion, trapped up in my dingy apartment and worrying about myself and my situation. Worrying about feeding myself, worried about school, worried about planning and most of all, worried about the future. I spent so much time worrying that I think I actually worried myself out. But slowly, Antigua worked at me, chipping away at me piece by piece. She’d get in eventually.

It happened slowly. My walks to the beach at sunset. Driving to and from the Epicurean to get myself groceries (and driving on the left side of the road, no less!) as well as haggling with the locals at the market for the best prices. All these little moments worked on me, transforming me into something more. I wasn’t aware of it at the time, and sometimes it seems funny to think about now.

Little by little, I got to see things on that island that I would never get to experience back home. Perhaps the most awe inspiring was the raw beauty of nature, everywhere I’d look. I’d spend my evenings gazing out over the waves, thinking about how vast the oceans are and by proxy, the world. Being there showed me how to appreciate myself, and my life. How to love life. Living in every moment, because you never know what the future brings. I set my worries aside and enveloped myself in the island. In the people, the culture, and the beauty.

I learned to be humble. Helped those less fortunate than myself. I learned how the human body works. I learned how to fix it when it breaks. I learned how to study, how to find beauty in little things, how to dissect a human being. I learned how to communicate with excellent professors, colleagues, and friends. I found Grace and I learned how to love. How to open my heart to someone else. I learned how to look to the clouds and see the whole world laying out before you. I learned how to look to the night sky and see every infinitesimal pinpoint of starry beauty, unspoiled by light pollution. Laying out the entire history of the cosmos in a symphony of light, the sound of gently swaying palm leaves in the breeze, and the smell of saltwater. I learned that sometimes things don’t go your way, but you need to keep trying if you ever want to succeed. I learned victory. I learned defeat. I laughed. I cried. I vomited. I thought. I pondered. I won. I failed. I was ME.

I met wonderful people. Kenny whom rented me my car and took care of me when it broke down. Lorena and Daniela who rented me my apartment and took care of me when I hit financial woes. I met wonderful professors, each with a story to share.

In the end, that scared little boy who stepped off the plane on August 28th, 2010 died. And he was laid to rest by a man. A man who finally came of age and learned how to take care of himself and the ones he loves. A man who finally determined how to accept responsibility and how to live a fulfilling life.

The evening before I left Antigua for the last time, I walked the beaches of Half Moon Bay with Grace. At that moment, my heart was so filled with love and happiness that I don’t think anything in this world can replicate it. The setting sun, her hand in mine, a smile on her face, the sand beneath my feet, the salt on the breeze, shells in my pockets and the gentle crash of the sea against our ankles. All of it. I’ve enshrined it in my memory forever. Nothing can replace it.

I made a promise to myself and to Grace that I’ll come back. Someday.

I promise.

This is a topic I’ve been meaning to write about for some time, and I finally just got a little free time away from school to do so. Thanks for bearing with me, readers!

SCAM-mers (SCAM = Supplements, Complementary and Alternative Medicine) are funny folks. Their grievances with the institution of Medicine are fought utilizing tired, easily debunked tirades appealing to mass hysteria to swing well-meaning patients to their cause. Instead of utilizing science and research to prove their points, they rely on slander, fear, and anecdotal evidence (It worked this way for ME!!) to justify their position. Today, I’ll look at one of the most common arguments they make.

“Doctors don’t treat the cause. They only treat the symptoms!”

How many times have you heard that from friends, family, neighbors, or just the good old quacks on the internet? It’s a common phrase, tossed around quite frequently. But is there any truth to it? Let’s try to shed some light on it.

Contrary to what most peddlers of nonsense wish for you to believe, I’ll go so far as to show my bias and proclaim that the academic training of physicians is rather rigorous. Despite the way some people may wish to paint us, we don’t sit in class and learn how to “toss drugs at a memorized list of diseases”, nor are we “glorified mechanics”. Our training begins at the molecular level, and we are taught how, why and when the human body works. We spend agonizing hours in the lab and the classroom learning how the body controls itself, as well as how it can be damaged. The very nature of medicine as a profession is to understand how human nutrition, environment, genetics and physical activity affect us as a species. And what’s more, the claim is slung around that we have “little to no understanding of these topics.”

Every physician’s first line of treatment is prevention. That’s what we are taught, and that’s the philosophy of medicine. We WANT our patients to exercise, eat healthy and live enriched lives. We encourage our patients to do these things. Preventative Medicine paves the way for lower healthcare costs, less morbidity and mortality, and an over-all healthy populace. However, we need to view this issue from both sides, not just one.

Take the average American. Studies show us he’s middle aged, overweight, probably Diabetic, sedentary, and lives on a diet of fast food. What’s worse, he may even smoke or drink (too much). When this patient visits us in the clinic, we will advise lifestyle changes. The average patient might take this to heart, and begin these changes. But statistics show this trend won’t last, and the patient more often than not “falls off the wagon”. And this is a best case scenario with patients who WANT to live the “preventative” lifestyle! What of those who are non-compliant? Those who don’t care to change? When these patients return to the clinic with uncontrolled hypertension or blood sugar, I need to do something. I cannot hold a gun to their head and force them to change. My only option now is the counsel them further and then prescribe a drug.  It is in this action that the quacks shout the loudest “You’re only applying a band aid! I TREAT THE WHOLE PERSON!”

We must also remember that there are also conditions that we cannot treat the root cause of. Diabetes is a good example. Yes, there are experimental drugs and treatments, but at the time of this writing the only thing we can do chemically IS treat the symptoms. That is the best that ANYONE can do. Prevention can help in the beginning, but eventually with most disease, pharmaceuticals are required. And these are administered as a last resort, and follow careful monitoring of the patient’s blood and other physical changes.

If there existed a magic, natural cure for diabetes, we’d already be using it. Countless websites claim to have the answer. “Use this supplement! It’s ALL NATURAL”. Forgiving the fact that “natural” products have just as many side-effects and complications as pharmaceuticals, and even forgiving the fact that most pharmaceuticals are simply the purified form of those aforementioned “natural” products, the fact that something is “natural” doesn’t automatically make it safer or better. If you’d like to eat Willow Bark for your headaches, be my guest. I however, will take Aspirin, the same “natural” cure purified of all the impurities and possibly toxic substances nature left in it. And I will know the exact dose I’m getting, along with a statistical knowledge of the likely side-effects. And I get the assurance that my medicine is clean and safer than what Mother Nature first started it as.

It’s hard to do, but we have to fight the fear mongering. I’m not saying that there aren’t problems in medicine. There are tons. But it’s the best we have, and quite simply, we aren’t using “alternatives” because they are either unproven, dangerous, or ineffective. As writer Tim Minchin says: “Do you know what they call Alternative Medicine that’s been proven to work? Medicine.”

And right he is. There truly is no such thing as “Eastern” or “Western”, or “Allopathic” medicine. We have what science has shown to work, and the rest is left to the realm of speculation or abandonment when it was shown to be ineffective or dangerous.

So in closing, don’t let people sway you from seeking medical care because your MD “Only treats the symptoms!” Honestly, I don’t profit from your misery in any way, nor do I make more money if I prescribe you drugs. If I can find an easy way to alleviate your pain or fix your underlying problem, I will use it. Otherwise, my only options are to help you feel and live the best possible way you can. And barring a few hucksters, that’s the motto of most doctors. We’re here to serve YOU, the patient. Not the other way around.

So take steps to make your life better. Exercise, eat healthy, stop smoking and drinking, and don’t use illicit drugs. But if there comes a time when that fails, don’t be scared to seek out medicine. We’ll give you the best shot that humanity has, and you’ll walk away from that knowing you can get information about any drawbacks, side effects, or complications. Every treatment is a doubled-edged sword, “natural” or otherwise. The benefit you get with us VS the “natural” is that we give you that information. Mother Nature doesn’t.

As always, stay healthy and stay skeptical folks.

Components of Informed Consent

1. Before patients can give consent to be treated by a physician, they must be informed of and understand the health implications of their diagnoses.

2. Patients must also be informed of the health risks and benefits of treatment and the alternatives to treatment.

3. Patients must know the likely outcome if they do not consent to the treatment.

4. They must also be informed that they can withdraw consent for treatment at any time before the procedure.

5. Physicians must also obtain informed consent prior to entering a patient in a research study. However, if a patient’s condition worsens during the study as a result of lack of treatment, placebo treatment, or exposure to experimental treatment, the patient must be taken out of the study and given the standard treatment for his or her condition

 -Behavioral Science, 5th Edition
 Barbara Fadem, Ph.D.

The last time you went to the Doctor and were prescribed a medication, sent on a treatment plan, or given counsel about your lifestyle, you were likely informed of the benefits. Were you informed of the risks?  Likely not. See, that’s the issue. Many Doctors today are in a hurry, and neglect to fulfill these important aspects of informed consent simply because time doesn’t permit. But is that really a decent excuse?

As clinicians, our duty is to our patients. Over all, their health is our top priority. However, the patient has full right as to what happens with their body, and rightly so. Our duty is to provide them with the knowledge they need to make an informed decision about their health, our recommendations pertaining to it, and any other choices that may have cropped up in their daily lives. In order for a patient to be truly informed, and thusly able to make that important decision, they need the unbiased factual knowledge that is currently known about the choice at hand. This is where personal biases and lack of knowledge (and sometimes sadly, laziness!) come to play. These forces, acting in concert, undermine the purpose of informed consent, and turn it into little more than a blurb to be tested on in relevant ethics sections of exams.

Pills, Thrills, and Shills

Obviously, one of the biggest parts of the Doctor/Patient encounter is the prescription of drugs for any wide variety of conditions. It’s no doubt exciting to the new doctor (speaking as a medical student) and probably hum-drum and dull to the experienced Physician. But, whether you are a green-horn intern raring to go, or a battle-hardened Attending who waxes poetic about the “good old days”, the same policies and principles apply.

When prescribing a patient a drug, you NEED to talk to them about it. Outline  WHY you are prescribing it, what the drug does, and what they can reasonably expect from it. This data should be gleaned from not only your knowledge of Pharmacology, but from the research you have done into the drugs you are desiring to prescribe. This entails reading *gasp*, Medical Journals! Keeping up on the literature is key, and serves to better inform you. Because let’s face it, institutions are slow and resistant to change. The drug du jour for a specific condition may not be the drug you are told to utilize by your institution, or your peers. When facing these discrepancies, you need to be informed so that you can take these concerns to the proper committee.

The patient also needs to know side effects. What are they, which ones are common, and again, what can the patient reasonably expect. This information is not difficult to obtain. It’s available via the classic Physician’s Desk Reference, or for the Tech-Age people among us, on programs like Epocrates on a smart phone.

A lot of people say “That takes too much time!” and yes, it does take time. However, that’s your DUTY to your patient. You make the time. You entered this career for a reason. Don’t forget that reason because you are tired, annoyed, overburdened with work from your Resident, or feeling lazy.

Supplements/Complementary and Alternative Medicine (SCAM) or: How I learned to stop worrying and trust the Science

As many of you know me well, you know I’m a staunch advocate of science-based medicine. This means only recommending or endorsing treatment options based on positive evidence from randomized, double-blinded, placebo-controlled studies. Medicine is a lucrative field for both Pharmaceutical Companies and “Alternative” Peddlers alike, and both will resort to trickery to try and take your money. However, while the marketing teams and corporate lawyers of Pharmaceutical Companies are crooked, their science is not. They have the benefit of reproducible, peer reviewed studies to back their claims. The drugs might cost too much, but they work.

“Alters” on the other hand, don’t have this luxury. They have to resort to testimonials from patients or celebrities, which are not valid evidence of anything. Along with this comes our duty to the patient, and informed consent. If a patient wishes to undergo an alternative therapy, I believe it’s our duty to inform ourselves about that therapy, study the claims of efficacy, and inform the patient of the side effects and likely outcome. Just as we would for any “conventional” drug or therapy.

If you want to try acupuncture, fine. But I’m duty bound to inform you that it’s been extensively studied and shown to have zilch on the way of effects greater than placebo treatment with sham acupuncture. I also should be informing you of the risks of infection (This IS an invasive procedure utilizing needles penetrating the skin!) as well as the reports of collapsed lungs and death. These are all very real side effects that have been documented extensively, yet most alt-medders tend to gloss over them without much thought, while yammering on about how terrible our pharmaceuticals are. However, with that information in mind, if the patient still wants to try, then that is their right, period. You’ve informed them of the necessary information, and they made an informed decision. Your job is done.

Conclusion

Above all, work with your patient. Develop a rapport with them, be understanding, and address their concerns. The above example may seem draconian to some, but delivered with tact and compassion, it’s very likely to work. You’ve done your job, the patient is informed, and is free to exercise their right to choice. Everyone wins, and everyone benefits.

It is in this way, Physicians don’t have to support quackery and health fraud, but can avoid alienating their patients.

Well dear readers, it’s time to unveil my latest brainstorm, the Infidus Rememdium.

The more astute of you may have figured out that Infidus Rememdium is Latin, specifically for “Untrue Medicine”. The purpose of this new section on my blog is simple. As time permits, I’m going to catalog various treatments and remedies that are currently popular in the world of complementary and alternative medicine. True, non-biased, scientifically valid information about alternative medicine is difficult to find, and when one does locate it, a good percentage of the laypeople are not well versed in interpreting medical studies and research to determine if they utilize sound methods and statistics. I’m going to do my best as someone in the field to flesh out specifics on each of these theories, and offer proof of their scientific invalidity, as well as discuss with you why they are useless or perhaps in some cases even harmful.

My ultimate goal is to use words the layperson can understand and can relate to, so they can make informed decisions about their health when most of the information presented to them over the rest of the internet is heavily biased towards quackery, frauds, and charlatans. I intend to use real world examples and simple explanations to link the information presented to important concepts about each topic.

For the first topic of the new section, I plan on discussing a little bit of the history of medicine, as well as talking about what really constitutes quackery, as well as a small dash of medical ethics to go along with it. We’ll talk about some of the common problems in the healthcare world today, and what further issues these problems compound.

As always, if you have any questions, comments, or suggestions for me (Or even hate mail!) feel free to send them my way. If you wish to see a specific topic covered, let me know so I can add it to the list.

Thanks as always dear readers, and I do hope you enjoy the coming project!

I decided to go with a new layout around here. I figured it would be more befitting my current situation! As always, let me know your opinions and thoughts.

Things have been more or less the same down here on the rock as they usually are. However, I did finally move into a new house. It’s a beautiful, newly constructed house that’s inland this time. I’m on the eastern side of the island at the top of a hill. This affords me a spectacular view of my surroundings. All in all, it’s very cozy and quiet, and perfect for studying.

The semester is not even one week in yet, but I already am back into the swing of things. Things start slow around here, but they quickly accelerate as time passes, so this is the inevitable calm before the storm. However, I’m used to that by now, and I am looking forward to the challenge that it will present.

My lovely girlfriend Halle is coming down to visit me next month, and then flying me back stateside briefly for her family reunion. I’m very much looking forward to the welcome break from slaving away over books.

I figure I’ll end it here, since I have some studying to do. As always, drop me a line whichever way you like!

As many of you know, I’m a staunch promoter of the scientific method when it comes to choices involving one’s health. What this entails chiefly is that when considering a treatment, drug, physical or otherwise, one should do research to see if the treatment has been tested and proven to work better than a placebo. This seems like it would be relatively simple to follow, but unfortunately, there is another element to this equation. Quackery. Nowadays, it’s very hard to determine who or what to believe when it comes time to choosing health related products or services. As a medical student, I would like to take the time to talk about how to avoid dubious products or services and how you can protect your health.

The age we live in currently is an age of mistrust of health care professionals. Most people have, at some time in the life, had a bad experience with a doctor. Many view us in health care as “only profit motivated” or as “butchers, poisoners, and burners”. Many people believe modern medicine has failed them. When at death’s door, or suffering with a chronic ailment, all people want is an answer or a fix, and sometimes we cannot provide that. These reasons above all, are why people resort to quackery.

More and more, a “natural” products method is beginning to sweep the nation. People distrust the prescription drugs available to them, and prefer to seek solace in herbal remedies, vitamin supplements and other forms of non-scientific healthcare. They believe it to be a simpler, more effective way to treat what ails them, and that it allows them to circumvent seeing the doctor. Nothing could be further from the truth.

Let me preface this by saying that I don’t agree with everything the Pharmaceutical companies do. As businesses, they are of course motivated by money, and will make unpopular decisions. However, the drugs provided by them are formulated in a scientific manner. When we discover a compound in nature that has a proven effect on human health, we analyze that compound to discover why it works, how it works, and what it works best with. Then, using that information, we formulate a specific dosage that has been proven to work best with human ailments. Note that just because the product may now be synthesized in a lab doesn’t make it any less natural. The molecules in that product are identical to its natural counterpart. However, due to the marvel of modern science, we are able to eliminate any potential toxic or uncontrolled substances in that natural product to purify it for human usage. In this case, natural is the worst way to go, and man-made reigns. It’s safer, more effective, and is accountable for any actions it causes. Plants and other herbs all vary in the wild in terms of their content, and could contain dangerous substances. It’s important to remember that supplements are NOT regulated by the FDA in the USA. Just because you see a product on the shelf does NOT mean it is tested and safe.

People just plain don’t like taking pills. And who could blame them? Sometimes the side effects are awful. However, this doesn’t mean there is an easy alternative. Side effects are just that: unwanted effects that cannot be removed from the synthetic formula. Drug companies do their best to synthesize formulas with the least amount of side effects (which are present in the natural form too, mind you) but sometimes they cannot succeed. However, people need to understand the cost/benefit ratio. A method is considered therapeutically viable if scientific tests show that it performs better than a placebo, and that the net positive effect of the drug outweighs the net negative effect. In essence, it’s a trade off. If there existed a natural supplement that achieved the same effects without the nasty side effects, the drug companies would pounce on it immediately so they could sell it. Unfortunately, that doesn’t exist, and likely never will.

And just how vigorous are these clinical trials I keep talking about? Most people don’t understand how modern medical testing works. There are several steps that take place, but the most important one calls for two (or more) groups of randomly selected people. One group will be given a placebo pill, and the other will be given the medicine being tested. The test is then double blinded. What does this mean? It’s a necessary step that ensures that neither the patients nor the researchers can attribute false claims or lies to the test. Both groups are unaware of whom got the placebo or the real medicine, so all that can be collected in the real, honest data. If, after all these steps, a drug proves that it has an effect on a problem that is significantly better than just a placebo, it will be considered for usage. Supplements you see on the shelves do not undergo this rigorous testing. And being unregulated, taking them along with other medications or drugs is basically Russian roulette. Who knows what could happen?

People don’t like science because it essentially dampers idealistic visions about things that people hold dear. For instance, the thought of using “ancient Chinese medicine” appeals to many, due to a feeling of mysticism. However, the rigorous tests described above prove that acupuncture doesn’t work even close beyond the realm of placebo.

People are also sold by charismatic salesman. The “doctor” of chiropractic that claims a vertebral subluxation is causing your back pain, and that he can fix it by simple manipulation. Again, modern science tested this theory, and the subluxation has never been shown to exist in over 100 years since chiropractic was first developed as a religious healing movement. Nerve impingement doesn’t lead to organic disease, yet chiropractors use scientific sounding words and baffle their awed clients with their supposed knowledge of the keys to unlocking the human body. What does the rest? Simple placebo effect, the intense desire for the treatment to work, and a laying of hands effect.

As previously mentioned, people don’t like being told that nothing can be done about their condition. So they figure, “why listen to the doctor when I can go to the store and get a bottle of kava extract, or bee pollen to help my ailment!” Unfortunately, science has shown that these products don’t work. Results garnered from them are purely coincidental. And in the case of Kava, it can cause liver failure. For a drug that has no measurable beneficial effects, this is a ridiculous risk to take. Examples like these show why the public is in danger.

Lastly, I hear sometimes that we as healthcare professionals are part of some massive conspiracy to keep the public sick, with the intent of lining our pockets. Let’s examine that statement for a bit. Can you rationally state to yourself that EVERY physician is merely out for money? Make no mistake, every profession has its bad apples, and there are certainly bad doctors. However, the majority of us are kind hearted people who went into this profession to truly be able to make a difference in the lives of others. I myself decided to adapt the calling when my own life was changed by a wonderful doctor who diagnosed and treated my panic attacks with the help of modern medicine. He gave me a normal life, and I wanted to return that favor to others. We study long hours, do backbreaking amounts of work and give up some of the best years of our lives to be able to serve the public as their healthcare providers. After all this, to still hear people tell me that I’m merely in this for money is disheartening. We work hard to help you improve your lives. Just give us a chance and trust us. Chances are, you’ll be a lot better for it. If you work with us instead of resisting us, it makes our lives easier, and yours as well, since we can better tailor a treatment plan that fits your life best.

So dear friends and colleagues, give science a chance. It KNOWS it doesn’t have all the answers, but it’s self-correcting. Science continually updates and discards what doesn’t work in favor of that which does. The old ways are tossed aside to make room for improvements. That’s how progress works. Don’t trust your health to unregulated methods or treatments. Stick to what has been shown to work, without a doubt.

And above all, remember that in practical application, there’s no such thing as “alternative” medicine. There’s simply medicine that works, and medicine that doesn’t. And unfortunately, science has shown that the majority of the so-called “alternative” medicines don’t work.

Stay safe, stay healthy, and have a wonderful 2011 dear readers!

Yesterday was a typical Monday morning for me. I woke up groggy at 5:30 cursing the morning sunlight, and did a disjointed zombie shuffle to the bathroom to shower and get ready. I crammed down breakfast, changed into my crisp blue scrubs and white sneakers, and hurried to catch the bus to school.

The punch of frigid air you get when opening the door to the anatomy lab is a harsh contrast to the overpowering Antiguan sun. Stepping in with my friends and colleagues, we laugh about the day and topics from lecture, passing rows of dismembered limbs and specimens. Forearms reach toward us, hands set in grappling poses, almost as if they are demanding a handshake from the passerby. Meanwhile, skeletons grin at us from every corner, lingering in the shadows.

We continue our jovial conversations as the Professor opens two metal freezer doors and rolls out a stainless steel cart, on top of which rides a body bag. I don my latex gloves and help unzip the bag, revealing our real teacher for the day. She’s an elderly woman, skin still a nice pinkish-red despite being embalmed with Formaldehyde. Her eyes are shut, and her mouth is pursed in a slight grin, almost as if she’s happy to begin today’s lesson. Helping my Professor, we grab hold of her and flip her prone, so that we may examine the posterior of her lower limbs. That is today’s lesson.

It’s funny how one can become accustomed to things that are so out of the ordinary for the every day person. As scalpel pierces her flesh, yielding vibrant yellow fascia with the consistency of scrambled eggs, no thoughts of horror are on my mind. Instead, I am excited. Excited to see exactly those structures which enable me to walk, hold me upright, and cause so much pain when injured. The professor shows us the Gastrocnemius muscle, it’s two heads still rather developed despite our “patient’s” advanced age. Reflecting the Gastrocnemius, the Soleus is revealed, so-named due to it’s uncanny likeness to a sandal.

My internal monologue is not screaming out in terror at receiving this visceral image of death in front of my face. Rather, I look upon my patient with an intense amount of reverence, being ever so thankful that she would allow me to experience this lesson with her. Her thoughtfulness and generosity extend far beyond the confines of mortality in that she would share this experience with me. Allow myself and my colleagues to view, inspect, and handle areas so private and hidden on her body that she herself never laid eyes on them.

Hours after the lesson are over, I remain in the lab, having secured permission to do so. With a small group of my friends, we continue our efforts in visualizing her body. We trace nerves, blood vessels, muscles and tendons, turning our heads back and forth between the patient and a colorful atlas detailing her physical geography. I reach my hands deep into her thighs, grasping the femur and feeling for the osteotic landmarks. Every now and then a cloud of embalming fluid wafts up to smack me in the face, causing my eyes to tear up. I simply cry it out, and continue on with my friends.

At the end of the day, we close the body bag up, and return the patient to the confines of the freezer. We wash our hands, change back into street clothes, and are out the door to eat lunch. We laugh and study over food, recounting the lessons of the day before lecture begins.

In the end, our patients will be returned to their respective homes to receive their last rights, and be interred as their last wishes specify. An honorable end to some of the finest educators I have ever had the pleasure to work with in my academic career.

Anatomy changes a person. Maybe subtly, maybe not. I guess it all depends. For me, the boundaries of life and death are blurred, but not in a way that makes them any less significant. By understanding this machine, this beautiful machine that each one of us is blessed with in so many different forms and variations, we can begin our journey down the path towards healing others. The lessons these patients give to us in death will forever benefit those patients who are still alive. And they will be carried with us, from Student Doctors to Interns, to Residents, to Attendings. Many things one can forget year after year, but I doubt I will ever lose these blessed lessons.

I prepared fresh pine needles from a tree in the back yard by trimming them with scissors and packing them into the thimble of the Soxhlet Extractor, utilizing cotton on top and bottom of the needle samples. I decided to try an organic solvent, and settled on denatured ethanol. I started with 100mL of the ethanol, and began the extraction process.

About halfway through the process, I found that 100mL was not enough, and added ~100mL extra to the Florence Flask. This allowed the proper siphon action on the side-arm of the Soxhlet.

The final distillate was not what I had expected. I received a yield of forest-green liquid which, upon wafting, smelled vaguely like pine, yet retained far too much of the original ethanol odor to be usable for aroma purposes. If I decide to repeat this experiment, I believe I will try either another solvent other than ethanol, or adjust the quantity of needles that I decide to extract from.

If anyone has successfully done this procedure, or has ideas as to how I might modify the experiment further, please let me know!

The Soxhlet Extraction of Pine Needles.

Close-up of the distillate and the pine needles.

Upper part of the assembly, highlighting the Allihn condenser with water flowing and the Soxhlet Extractor.