When hardliners fight over what they believe to be in the best interests of clients, those who simply seek a wellness solution that meets their own needs, then we’re being no more helpful than superpowers bombing civilians so as to prove supremacy over each other.
Archibald portrait model Tim Minchin (shown in 2-dimensional form) is often quoted from his rant ‘Storm’, “Do you know what they call alternative medicine … That’s been proved to work? Medicine.” Storm is another guest at a dinner party, who commits the heretical crime of suggesting that the ‘human body is a mystery’. Deemed guilty by Tim, and having prior convictions (indicted by a butterfly tattoo), she’s fair game for ridicule.
From two generations of surgeons, Tim’s acquired a disposition toward bullying, and incited by her claim that Big Pharma is ‘immoral and driven by greed’ he launches a hilarious, albeit vicious attack – for our amusement.
He’s right, up to a point. An example is linked. In determining which holistic (i.e. considering mind and body jointly) therapies are beneficial in a chronic pain syndrome, the successful mindfulness study was classified as being psychotherapy. This despite the clinical trial being by a Dr Schubiner who’d studied under mindfulness pioneer Jon Kabat-Zinn at U.Massachusetts Med School, and his book ‘Unlearn Your Pain’ copied MBSR meditations. Proven success means it’s called medicine. Not alternative, allied health, or complementary. It’s mainstream. Mmm ‘kay!
Medicine is overly silo-based, and Integrative practitioners rare, so be very appreciative if your GP is holistic. Most doctors’ training drew demarcation lines at the base of skull. Do Not Cross! Complementary/Alternative Med (CAM) therapies consider body & mind together, which means they’ve stolen a march on the physician who’s failed to keep up with advances in neuroscience. Including mind states in treatment regimes means that Complementary Medicine (CM) is better able to exploit the rapidly growing evidence base built with use of advanced fMRI techniques, or even consumer EEG devices.
Back to the poem attacking CAM as unscientific. After a potty-mouthed reference to the Pope, I take further exception to these lyrics ‘Let’s go watch Oprah, interview Deepak Chopra’. You’ll find that the sledged New Ager is actually relying on science. Harvard is just one of six Universities that his institute has tasked with testing as to whether meditation can reverse biological markers of aging. Deepak’s Ayurvedic founding could be laughed away as Eastern mysticism, or admired for its plain commonsense. One’s temperament (dosha) deserves consideration in therapy – be it airy, hot&cold, or earthy. Standby for catchup from your doctor. The newfangled proposal in medicine is to customise care to the patient, exploiting genetic profiling advances. Just … be … patient …
Going further, and beyond my comfort zone (having not read a horoscope in decades) there’s a cynical dismissal of Storm’s starsign – followed by Tim’s gloating endorsement of a pain pill, aspirin. This treebark derivative is oh-so very important in the early stages of a heart attack. It breaks up clots. This was proven beyond doubt in 1988 with a massive study published in the Lancet here, but just for fun, the cardiologists analysed birthdates as a factor. Oxford’s Peter Sleight found that this benefit wasn’t true for Gemini (inconsistent? Well, hellooo…!), and Librans (another contradictory sign). Me, I think that if your personality has been moulded to a certain disposition from birth, then you’ll end up behaving true to form. Like it or not, astrology provides an insight into how you’ll respond to a medication. I simply have to accept this science, even if it raises questions *. The facts are 1 in ten thousand that it’s a fluke conclusion (p=0.00001). But science which you choose not to believe in becomes a matter of faith, Tim.
Even more remarkable is the fact that it’s taken over a century for interest in willow bark to really take off. The NHMRC’s largest grant allocation is to ASPREE (aspirin for reducing events in the elderly), with each of its 13 substudies examining benefits for a single disease. Advances in medicine are rarely as cataclysmic as Catalyst (ABC TV) would have you believe. Too much hype is generated with each and every new insight, to help secure the funding for nurture of a new pill through its first dozen years. From the lab to the pharmacy is an arduous and expensive journey, which then leads onto longterm uncertainty about undesirable side effects. The pharmacovigilance movement, spearheaded by Professors Gotzsche (‘Deadly Medicines’) and Healy (‘Pharmageddon’), and Dr Goldacre (‘Bad Pharma’) comprises many industry insiders turned whistleblowers. The foundations of medical science aren’t quicksand, but nor are its truths set in stone.
A cheap shot is an easy one, since Minchin’s fans can readily recall stereotypes that endorse his posit. So let’s explode a myth. The most vocal perspectives from alternative health come from the anti-vax lobbyists. But often the truth is first casualty, and a systematic review in the journal ‘Vaccine’ of Aug 2016 breathes equanimity into opposing camps. Collating all articles that report on CM practitioner & advocates’ attitudes to childhood vaccination, no evidence was found indicating any association that may influence parental decision. Included studies ranged from 93% of chiropractors being either pro-vax or else unqualified to advise (Lee & Kemper 2000), to 76% of naturopathy users uninfluenced or deciding in favour of vax after practitioner discussions (Busse & Wilson 2011). Despite the confounding issue of selective immunisations instead of multijab, it’s already clear that CM doesn’t mean Closed Mind.
There’s no need for a divide in healthcare. Them or Us is a manufactured construct, which isn’t in the interests of the patient or client. It behoves no-one to sanctimoniously sneer at the opposition, as was evidenced by Health Minister Hennessy’s very public bullying by anti-vax trolls.
The take-home point is to choose carefully your dinner guests. Avoid smartarses. Storm rides out the insults with her dignity intact, drawing upon classical posits. Her Shakespeare quote switching ‘dreamt’ and ‘exist’ reflect the everyday phenomena studied by Horatio at Wittenberg Uni as being at odds with a talking ghost (Hamlet 1.5.167-8). Me, I rarely get to dine with company – but Carole is all I need.
* Biostatisticians out there will be aware that the principle at stake is subgroup analysis, condemned as anathema but exploited for their own purposes by Schultz, Chalmers and Altman in Feb 1995 Jnl of American Medical Assn. Only available in the original hardcopy. I was generously sent a copy by Doug Altman, whereupon I challenged his hypocrisy. No reply.