Treason and Alternative Medicine

“Treason doth never prosper;

what’s the reason?

Why, if it prosper,

none dare call it treason.”

Ovid, translated by Sir John Harrington

The first time I heard this line was from a teacher named Mr. Sagan (no, not Carl, a different Mr. Sagan), though he didn’t attribute it IIRC. I had just rather daringly  suggested that George Washington was not “a great patriot” at all, but a traitor to his sworn vow of loyalty to King George. Frankly I was just being contrarian for the most part, but Mr. Sagan  then and on several other occasions complimented me for thinking outside the box and  proceeded to examine the assertion on its merits.

Thanks to him, I came to understand that there could be multiple  interpretations of the same data; that Washington was both a traitor and a patriot, and that the same could be said of any leader of a successful revolution, or even an unsuccessful one if one was in a generous mood. (Robert E. Lee is often seen so.)

If I had the oratorical gifts of an Ovid or a Sir John Harrington I would make an equivalent statement about ‘alternative therapies’ (“Cures it the sick? Then that we’ll pick!” – nah!); alas, I’m not even a Tim Minchin.

“By definition”, I begin
“Alternative Medicine”, I continue
“Has either not been proved to work,
Or been proved not to work.
You know what they call “alternative medicine”
That’s been proved to work?
Medicine.”

Now, I can understand people following the first half of Tim’s definition, those therapies which have not been proven to work. If you’ve been down the road of proven therapies, and they haven’t worked in your particular case, it makes perfect sense to try something new, or something old but unproven. Indeed, the advance of medicine depends upon people trying such things; every effective new therapy began with someone trying something unproven, out of some combination of  desperation and courage. Sometimes the base of the therapy is a novel molecule which never existed before, sometimes it is some traditional herbal preparation prepared by a shaman or witch doctor.

The trouble with relying on tradition and mysticism is that there’s no error checking. The successes, which may have been coincidental, get  remembered, the failures don’t.

The old joke is that doctors get to bury their mistakes. That’s very true of alternative medicine, but it’s no longer true  of western medicine – mortality and morbidity are studied exhaustively with powerful and dispassionate statistical tools, and therapies which don’t work are abandoned. There’s no “My cousin Barry took Screwitol and got better, so I believe it works” in Western medicine; it’s “In a controlled study of 10,000 patients who took Screwitol and 10,000 who took a placebo (i.e. only thought they were taking Screwitol), the ones taking the actual therapy did worse/better/the same” and only the ones that actually work are kept.

Alternative therapies rarely do so; it’s rarely possible to do so, given the inherently vague and non-reproducible nature of them, but even in the cases where it is possible it isn’t done. Most alternative therapists avoid such testing of their methods like the plague, so to speak, and for good reason; when examined with the dispassionate and effective tools of science they very often turn out not to actually work.

That’s not always the case, of course, especially in the arena of herbal remedies; lots of traditional herbal remedies, when so examined, turned out to be effective. Lots of others, including many that people had sworn  by since time immemorial, turned out to be worthless or actually harmful; even though someone’s sister or Dad can always be found who used them and got better, the truth is they just got lucky and the treatment didn’t actually cure them.

Controlled studies and dispassionate statistical analysis of the results don’t tend to make people feel warm and fuzzy, and there’s certainly something to be said for feeling warm and fuzzy – for one thing, controlled studies and dispassionate statistical analysis have shown warm fuzzy feelings to be therapeutically beneficial in many cases.

If there are alternative therapies out there which may help a given condition, I want them studied with scientific rigor. If (as is usually the case) the science shows they don’t really work at all, then I’ll pass, and save my time and money. If the science shows they do in fact work, they won’t be alternative any more, now will they? They’ll be proven treatments.

Just like George Washington was a patriot.

Science doesn’t necessarily have an explanation for everything that works; the first step in development of many a scientific paradigm might be summarized as “We’ve proven through controlled tests that this works, we don’t know why yet.”

The second step is developing some theory which might explain the data; it’s unlikely that this theory will involve spirits or entire other dimensions of being, but that’s because scientists have found such theories unjustified in pretty much every case they’ve investigated. There’s no real reason to suppose that will change; it’s not strictly speaking impossible, but experience has shown that pursuing such a theory has always been a waste of time.

Theories which have worked, i.e. have produced useful predictions which worked out in practice to aid in the medical treatment of people suffering illness include such counter-intuitive gems as the germ theory (“There are living or quasi-living beings so small they cannot be seen which can interfere in the health of humans and other animals we can see with the naked eye”) and the genetic dysfunction theory (“All adult living beings are the result of phenotypes expressed by some combination of chemical sequences or genotypes, and sometimes those genotypes are faulty and produce less than ideal phenotypes”). These were quite deeply weird ideas for their time, but they worked – if you made the assumption that they were true, the theories predicted results that obtained.

If you assume that a parallel spirit world exists and diseases can be cured by shamans entering a trance, usually drug-induced, and battling demons of illness there… well, frankly, it’s so out there that it’s not worth a scientist’s time investigating. At most, a scientist might set up a study in which the results gained by genuine shamans were compared to those obtained by skilled actors. It would be easy to obtain the actors, but the shamans I suspect wouldn’t want to take part.

Less folkloric stuff which depend on ‘energy fields’ and the like, such as ‘crystal healing’ and homeopathy and astrology and chiropractic fluxions have been investigated by scientists, and the results have been largely unambiguous; they don’t work. Sadly, this doesn’t deter the true believers, who continue to fill the wallets of charlatans.

The trouble with relying on tradition and mysticism is that there’s no error checking. The successes, which may have been coincidental, get  remembered, the failures don’t.

The old joke is that doctors get to bury their mistakes. That’s very true of alternative medicine, but it’s no longer true  of western medicine – mortality and morbidity are studied exhaustively with powerful and dispassionate statistical tools, and therapies which don’t work are abandoned. There’s no “My cousin Barry took Screwitol and got better, so I believe it works” in Western medicine; it’s “In a controlled study of 10,000 patients who took Screwitol and 10,000 who took a placebo (i.e. only thought they were taking Screwitol), the ones taking the actual therapy did worse/better/the same” and only the ones that actually work are kept.

Alternative therapies rarely do so; it’s rarely possible to do so, given the inherently vague and non-reproducible nature of them, but even in the cases where it is possible it isn’t done. Most alternative therapists avoid such testing of their methods like the plague, so to speak, and for good reason; when examined with the dispassionate and effective tools of science they very often turn out not to actually work.

That’s not always the case, of course, especially in the arena of herbal remedies; lots of traditional herbal remedies, when so examined, turned out to be effective. Lots of others, including many that people had sworn  by since time immemorial, turned out to be worthless or actually harmful; even though someone’s sister or Dad can always be found who used them and got better, the truth is they just got lucky and the treatment didn’t actually cure them.

Controlled studies and dispassionate statistical analysis of the results don’t tend to make people feel warm and fuzzy, and there’s certainly something to be said for feeling warm and fuzzy – for one thing, controlled studies and dispassionate statistical analysis have shown warm fuzzy feelings to be therapeutically beneficial in many cases.

If there are alternative therapies out there which may help a given condition, I want them studied with scientific rigor. If (as is usually the case) the science shows they don’t really work at all, then I’ll pass, and save my time and money. If the science shows they do in fact work, they won’t be alternative any more, now will they? They’ll be proven treatments.

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~ by B.T. Murtagh on September 3, 2009.

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