{"id":613,"date":"2006-09-19T11:39:45","date_gmt":"2006-09-19T11:39:45","guid":{"rendered":"http:\/\/scienceblogs.com\/principles\/2006\/09\/19\/the-path-to-woo\/"},"modified":"2006-09-19T11:39:45","modified_gmt":"2006-09-19T11:39:45","slug":"the-path-to-woo","status":"publish","type":"post","link":"http:\/\/chadorzel.com\/principles\/2006\/09\/19\/the-path-to-woo\/","title":{"rendered":"The Path to Woo"},"content":{"rendered":"

My pseudonymous colleague Orac<\/a> makes it part of his mission to lampoon “alternative medicine” wherever he encounters it, so this may well piss him off: For the last several weeks, I’ve been taking a daily dose of pseudoscience<\/a>. Why? I blame the medical establishment, but you’re going to have to click below the fold to find out why.<\/p>\n

<\/p>\n

As I’ve mentioned here several times, back in January, I started having very bad heartburn more or less constantly. After a couple of visits to my doctor, I was referred to a gastroenterologist, who scheduled an endoscopy, and then proclaimed that I have “gastro-esophogeal reflux disease,” or “GERD<\/a>.”<\/p>\n

What does that mean? It means that I have very bad heartburn a lot. Why? Good question. I’d love to hear a good answer. It’s apparently just one of those things. Take some pills, and it’ll go away, or maybe it won’t. Tough to say, really.<\/p>\n

This is, as you might imagine, intensely frustrating, probably more so for someone who is a scientist by training. Even in a complicated system like the human body, I expect events to have identifiable causes, and the notion that I could go from having no real stomach problems to having very bad heartburn all the time essentially overnight without<\/strong> there being an identifiable cause is just maddening. Still more annoying is the fact that the gastroenterologists aren’t particularly interested in trying to identify a cause– it’s just one of those things, shut up and take the pills.<\/p>\n

The core problem here is that “GERD” is a description not a diagnosis. Well, it’s a little more than that– they can explain the mechanism by which acid gets out of the stomach and causes heartburn– but it doesn’t provide the sort of information about causality that is the common connotation of “diagnosis.” There really ought to be another word for this sort of thing, where they clump together a group of common symptoms, assign an acronym, and call it a day.<\/p>\n

There probably is<\/strong> some sort of specific cause. Or, rather, some collection of causes, since it’s not clear that “GERD” really is one thing, rather than a collection of generally similar conditions. The advice they gave about diet and behavior was really hit-or-miss (more miss than hit, really), and the literature is loaded with “may”‘s, which suggests that there are different things going on. Heartburn may or may not be triggered by food containing garlic, and the “may” and “may not” groups of people probably have slightly different things going on. But figuring out exactly what’s going on is too complicated, so they get lumped together in a single condition.<\/p>\n

(I should note that, in the grand scheme of things, this is not a terribly important condition. It’s not debilitating, just very, very annoying. If somebody’s going to sink a lot of effort into teasing out fine biochemical distinctions between similar but related conditions, I’d rather they do it for cancer or AIDS– I’ll live until they get around to GERD.)<\/p>\n

This is the sort of situation that leads very easily to pseudoscience. A good chunk of the advice I got from actual doctors was little better than folk medicine, anyway, so why not try other things? In particular, a lot of people swear by eating yogurt as a heartburn cure, attributing the benefits to the bacteria. Now, I personally find yogurt disgusting, but they sell the bacteria in capsule form, so why not?<\/p>\n

Does it work? Enh. I’ve felt pretty good the last several weeks, but things had started to improve before I started taking the pseudoscience pills. Is there a causal relationship between my relative lack of heartburn and the pills? Tough to say, really. They didn’t make things worse<\/strong>, though, and I already paid for the bottle, so I’ll keep taking them for a while longer.<\/p>\n

The real issue here is the difference between acute and chronic conditions. Modern medicine does a really good job with acute conditions, things that have an obvious and immediate cause that can be treated directly. Those successes lead people to expect something similar for all medical problems, but there are a large number of chronic conditions that modern medicine just isn’t equipped to deal with at the moment. In addition to the recent heartburn thing, I’ve had intermittent back trouble for years (owing to bad posture and playing rugby in college), and there’s not a lot that can be done for that, either.<\/p>\n

Given a chronic condition that’s sufficiently annoying, and a medical response that amounts to a great big shrug, it’s natural for people to end up trying other things. And some of those things are bound to work for at least some of the people who try them, whether because of some actual beneficial property of the treatment applied or through the magic of the placebo effect. Which is how you end up with Ph.D. scientists taking non-FDA-approved capsules for stomach problems (which, I might add, were recommended to me my several other people with Ph.D.’s). It might work, and probably won’t hurt, so why not?<\/p>\n

Does this mean that I think Orac is a Bad Person for bashing on “alties”? No, because there’s a point where advocacy of “alternative” therapies crosses the line from “why not?” to “dangerous fraud.” It’s roughly the same as the line between “acute” and “chronic” as I used the terms above. If you’ve got stomach problems for some unidentifiable reason, there’s nothing wrong with trying a few folk remedies in tandem with conventional treatment (I’m not sure the Nexium is really doing much good, but I’ll keep taking it, too). If you’ve got stomach problems because you’ve got cancer, skipping chemotherapy in favor of vitamin C pills is foolish. Telling other people that vitamin pills will cure cancer is irresponsible, and telling them that they should skip chemotherapy in favor of vitamins is criminal.<\/p>\n

But I can’t help having some sympathy for people with chronic conditions who reach out for other sources of relief.<\/p>\n

(I wound up writing this post now because of a spot of excitement last week, in which Kate suffered bad stomach cramps and diarrhea, badly enough to require a late-night run to the emergency room. She’s better now, and the preliminary diagnosis is “colitis<\/a>,” which means “inflammation of the colon leading to bad stomach cramps and diarrhea.” What causes that? Good question. It’s apparently just one of those things…)<\/p>\n","protected":false},"excerpt":{"rendered":"

My pseudonymous colleague Orac makes it part of his mission to lampoon “alternative medicine” wherever he encounters it, so this may well piss him off: For the last several weeks, I’ve been taking a daily dose of pseudoscience. Why? I blame the medical establishment, but you’re going to have to click below the fold to… Continue reading The Path to Woo<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"1","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[45],"tags":[],"class_list":["post-613","post","type-post","status-publish","format-standard","hentry","category-medicine","entry"],"_links":{"self":[{"href":"http:\/\/chadorzel.com\/principles\/wp-json\/wp\/v2\/posts\/613","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/chadorzel.com\/principles\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/chadorzel.com\/principles\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/chadorzel.com\/principles\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/chadorzel.com\/principles\/wp-json\/wp\/v2\/comments?post=613"}],"version-history":[{"count":0,"href":"http:\/\/chadorzel.com\/principles\/wp-json\/wp\/v2\/posts\/613\/revisions"}],"wp:attachment":[{"href":"http:\/\/chadorzel.com\/principles\/wp-json\/wp\/v2\/media?parent=613"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/chadorzel.com\/principles\/wp-json\/wp\/v2\/categories?post=613"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/chadorzel.com\/principles\/wp-json\/wp\/v2\/tags?post=613"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}