The tragic outcome of a homeopath treating his daughter's eczema

It is devestating to hear stories of people deluded into believing that alternative medicine can cure ails.

It's even worse when the one who suffers never had a choice in the matter.

In England, a homeopath is on trial for gross criminal negligence after his daughter died of a skin infection. She could have easily been treated by a dermatologist, but instead, the father, a homeopath, provided only homeopathic treatment, the jury was told.

"The court heard that by the time Gloria was six months old, the eczema had begun weeping and her clothing and nappies would stick to her skin and tear it whenever her parents changed her.

"Crown prosecutor Mark Tedeschi QC said the baby girl's skin began to peel off, allowing infections to enter her bloodstream."

Her body couldn't handle the repeated infections, and she died from septicemia in May 2002.

Had homeopathy been explained to Gloria, I bet even she could have seen the folly of using mere diluted water to treat her raging skin condition and ensuing secondary infections...

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First do no harm...unless you haven't gone to medical school

Albert was on the phone with his sister on a sunny afternoon last week, telling her about the trip they had gone on over the weekend and his wife's bingo winnings at the local senior's centre that week, when suddenly she interrupted. "Albert, don't be silly."

"What are you talking about?" he replied.

"Albert, I can't understand you, what's going on?" He was confused - he was speaking perfectly fine, as far as he could tell.

His wife walked into the room, and noticed that he was indeed slurring all his words, and rushed him to their naturopath. The naturopath saw his mouth drooping on one side, and told him he knew exactly what was going on. He promptly gave him a glass of water, into which she had mixed several spoonfuls of salt, and told him to drink up, and encouraged him to do this over the next several days. Why?

Because, as the wife explained to me, "Well, when the left side of the mouth droops, he has a deficiency of sodium. And when the right side droops, he is low in potassium, you see. When both droop, then he needs more calcium."

Sure enough, in about half an hour, his droop had resolved, and his speech returned to normal. So the naturopath was right, right?

Unfortunately, in this case, his naturopath was wrong. Because he'd had a heart attack in the past, and his heart muscle didn't contract the way it should anymore, giving salt to this patient was a bad decision. In fact, research shows that patients with heart failure have worsening of their symptoms when they have salt in their diet, and the most recent heart association guidelines recommend low-salt diets for these patients.

And why did he get better? It had nothing to do with chugging brine. He'd had a TIA, or a transient ischemic attack, exactly like a stroke except it's just that - transient. The brain is starved of oxygen for a short time because of low flow or a small clot blocking an artery, but then the flow is restored before brain tissue dies. Had this lasted long enough to kill the brain tissue, it would have been called a stroke; in his case, the symptoms - temporary paralysis of his facial nerve innervating the orbicularis oris muscle, causing a mouth droop on one side - went away about half an hour after he drank the salt water. Though it looked like the natural treatment worked, it in fact had nothing to do with his symptoms resolving.

But, because of this advice, his wife faithfully gave him several spoonfuls of salt every day, causing more and more water to build up in his blood vessels. And it wasn't long before his failing heart couldn't cope with this excess salt. He soon could walk shorter and shorter distances without having to stop for air, and would wake up gasping for breath in the middle of the night. His heart muscle's ability to pump blood, which had been measured right after his heart attack as still being still quite reasonable, couldn't cope with the extra water in his blood vessels and took a drastic turn for the worse.

I saw him when he came into the hospital with his wife, unable to breathe, but it was too late. Despite receiving massive amounts of diuretics, vasodilators, and being placed on a breathing machine, it was too little too late. A few weeks later his heart gave out completely, he died with his lungs full of water instead of air, with a look of panic on his face, gasping for oxygen, because of the misinformation the wife had been told naturopath.

It doesn't worry me that naturopaths provide a whole-person approach, and attempt to treat the cause of patients' ailments rather than the symptoms.

It does worry me when they cause harm to patients, and make their health worse.

Any doctor that prescribed salt to a patient with heart failure... not to mention miss the diagnosis of a stroke... could be sued, successfully, for malpractice.

It also worries me that out on the western coast of this country, in British Columbia, naturopaths have been given the right to prescribe medications,which not only seems to go against their entire profession's objective of treating things naturally, but is possibly dangerous given that they are quite simply not trained in this area.

But going back to the story...you know what the worst part is? Had he seen a physician earlier, this could have been avoided... but the wife didn't see it that way. She left the hospital, without her husband, thinking that traditional medical treatment had failed to save her husband, when in fact the damage had been done long before he got to the hospital. Hopefully, her stronger belief in natural therapy doesn't kill her too.

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My new favourite blog: Science-Based Medicine.

Are You Clean Inside?

You may have seen them. The websites that promote natural healthy cures if you buy a certain product. Liver cleanses, colon flushes, to rid the body of 'toxins' and 'caked-on stool inside the colon.'

The websites themselves can be pretty convincing. They use big scientific words, often refer to accurate physiology to support their claims, and most of all, are full of testimonials from people who swear the product worked on them (a big red flag...real doctors make treatment decisions based on scientific studies, not testimonials).

Therefore I'm excited to introduce you to Science-Based Medicine, a blog I found while looking up some drugs that naturopaths were prescribing to a friend (admittedly out of fear for my friend's well-being).

Written by a surgeon, it discusses a number of naturopathic, natural, and alternative treatments from a person with much more medical experience than I have. Which I find refreshing because, as I said, with all the accurate facts mixed in with the bogus claims, these websites can be somewhat convincing and be somewhat successful at hiding the con within, even from a person like myself with six years of university training in biology.

Yes, I used the word con. That's the strongest word I've used towards any complimentary or alternative treatment on this blog to date. While I have in the past admitted to trying to be open-minded towards alternative treatments, some of them are just flat out there to con you.

As an aside, my friends who are studying to become naturopaths tell me they will spend most of their careers trying to distance themselves from these blatant conmen "that make us look bad," as they assure me there is still some science to what they practice (I will admit, though, that my goal of keeping an open mind to at least some of what they practice continues to grow an increasingly difficult task).

But more on the cons.

Consider the Liver Cleanse, which claims to flush out gallstones without surgery.

Or the Colon Cleanse, which claims to flush out toxins and caked-on stool from your colon.

While the websites can be convincing, Science-Based Medicine reveals them for what they are: absolute money-grabbing frauds. The author debunks the Liver Cleanse here, and the Colon Cleanse here.

If you don't want to read the full description there, in short, the very 'cleanse' itself becomes the things you think you're getting rid of: items you eat when taking the "Liver Cleanse" clump together to form objects which look like gallstones... and the very powder you take for the "Colon Cleanse" (clay and fiber) clumps together to form objects which look like caked-on toxins. All of which can be fished from your stool, photographed, and submitted to the website at will, along with your name and city, to be added to the list of testimonials.

And about all those "caked-on toxins and stool'? The surgeon states that in all his years of opening peoples' bowels, he has never seen anything like that in an actual person's intestines.

Please don't be the next victim to these scams. Ask your doctor about anything you're unsure of...and ask them to perform a search of the scientific literature if it's a treatment they're unaware of. Because some of these don't just take your money...they can actually cause you harm.

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Interdisciplinary health care: a gold mine being ignored?

...Continued from Preliminary Thoughts on Interdisciplinary Health

For interdisciplinarity being the newfangled wave in health care, throughout my time in hospitals and med school, I sure haven't gotten the sentiment that it's put into action very much.

After reading my previous post, my naturopath-student buddy asked if I'm for or against interdisciplinarity. I want to be clear: I'm not against it at all; I think that there's a lot to gain from it, if implemented properly ... i.e. not in the forced way described by the "Anonymous Therapist" commenter on my previous post.

My point is simply, I haven't seen much interdisciplinarity in action or even in theory at this point in my medical training, despite its lauded usefulness.

In fact, even though I'm only less than a quarter of the way in, to date I've felt the sentiment actually leans toward the opposite, almost against interdisciplinarity. I haven't felt much like we're being told to consider all those other professions as peers, equally-valuable limbs and body parts of the conglomerate, undoubtedly creepy-lookin' monster that is the health care industry. Can't function without the others, you can't live without one body part, so the interdisciplinarists might say (I'm abusing that word, aren't I?).

So how might the average medical student who has gone through the same training I have respond to this equal-value-body-part-organism metaphor? They'd probably say, "hey, you can actually live without some body parts. Naturopaths - they'd be the tail! Better off without 'em. You don't need a tail. You can function just fine without one. Humans, the smartest beings on earth: no tail. And we're better off for it...even the dumbest of us can't run in circles chasing it, which makes them look smart, because some people I know probably would chase their tails, if they had one."

Note that I said the average medical student - again let me point out this is not my opinion. In all honesty, I do feel myself and my profession could stand to learn some things from her and her profession. What I am talking about is the sentiment that I've felt to this point in medical school. Given the lack of interdisciplinary discussion at this point in our training, I wouldn't be surprised if a good number of my classmates thought like this.

Where do I get this impression? Experiences like, say, the time when one of my professors actually mentioned naturopaths directly in one lecture: "Sprinkle some herbs over a bunch of white beads and give that to a patient to eat? How will that help the patient?!" Yep, interdisciplinarity in action. That's what we've learned about naturopaths to date in medical school. And you wonder why some doctors look down on naturopaths.

Chiropractors? There's a whole other topic. Based on how some of my colleagues view chiropractors, in this organism of equally-valuable parts they'd rank chiropractors as, say, the appendix (ie. another organ of no known usefulness). One med student asked me, "How come chiropractors get to call themselves doctors?" Clearly subtle hints of superiority are more than evident in that statement. Another med student told me about her experience volunteering in a rehabilitation ward, and told me, "I was shocked at how many of the patients there were rendered paraplegics because of a chiropractic adjustment." Not a shining commendation by any means.

Moving away from hearsay: my limited experience with chiropractors, when I accompanied a friend on an chiropractic visit, was that the adjustments were very much aggressive, near-violent; and the doctor was very much like a salesman, near-slimy. My honest opinion of them, however, is I have yet to see first-hand any harm they have done, and I have read testimonials saying that they have made a huge positive difference in some patient's lives (but so have miracle healers...hmm).

And what about the ol' D.O., or Doctor of Osteopathy? Thanks to ads at test-prep courses and in pre-med literature aimed at pre-professional students and mostly worded along the lines of "Have you considered D.O.?" (which actually come across as "Hey eager pre-med student, have you considered D.O. as a backup plan should you be too dumb to get into med school and yet still crave the feeling of being called 'doctor?'") an impression of this profession among medical students as being a profession for pre-meds not smart enough to get into med school might be understandable. Fortunately, in a random encounter starting a conversation with a stranger on a park bench in London last year, I have met a D.O. student and know that to not be true.

D.O.s claim that they are another type of doctor, "equal to M.D.s in the eyes of the law." So why aren't D.O.s mentioned in medical school then? Maybe it's just because I'm in a Canadian medical school, but I think there's more to it than that...

So would I go see a chiropractor or a naturopath or a DO? Right now, probably not.

Would I recommend patients see one? At this point, I don't think so.

Based on my impression of them (admittedly based on anecdotal comments and impressions from friends) I haven't been convinced they do more good than harm. But would I recommend against a patient seeing one, or try to stop a friend from going to see one? Nope. I might pass on the paraplegic story, but I'm not against people finding what works for them, and I haven't been entirely convinced that these other practitioners do more harm than good. And if my smart friend is convinced enough about naturopathy to pursue a career in it, there's gotta be some merit to it.

Would my preferences change if I were taught the merits and capabilities of these professionals and believed that evidence showed they are medically indicated and make a significant positive difference in certain conditions? Definitely.

Like I said, while the conceptions I hold now may be misinformed or even grossly incorrect, I do believe there's value to be gained from interdisciplinarity, and I consider myself open-minded and willing to change should I be proven wrong.

The thing is, at this point, I haven't had the chance to go look up this evidence on my own. Not because I'm lazy, but because I've been too busy learning the things my medical has deemed important... and this isn't one of those things. But supposing I take the initiative to look this up on my own; what about the other students in my class? How will they know what to think about chiropractors and naturopaths and DOs other than what they've heard from their friends or seen on YouTube? Hopefully you can see why I think that training future doctors should involve discussions about these other healthcare professionals, because I do think that medical professionals have a lot to gain from an interdisciplinary mindset and from each other.

So far by discussing 'interdisciplinarity' I've mentioned practitioners seen as more alternative (the DOs and chiros will hate me for using that term, the naturos have to live with it), but this extends to all sorts of therapists and healthcare workers that don't call themselves 'doctor.' And yet, despite the fact that interdisciplinarity can be a huge benefit, if you were to ask ten people in my med school class what an occupational therapist does all day, I'd be shocked if more than one of them could tell you. Same goes for a respiratory therapist, or a licensed professional nurse, or a naturopath, even. I happen to know in great detail what each one of those does, with no thanks to my med curriculum (up to the end of first year) - I simply happen to have had three friends going to school for OT and have talked to them at length about what they do; I've volunteered for a couple years under a respiratory therapist; my mom is a LPN; and I have another good friend in naturopathy school. But if I relied on what I've learned in med school, well, I'd know nothing about these professions, nothing about how to help a patient access the valuable services these therapists have to offer.

I honestly hope that my school starts touching on these other important parts of the health-care profession as I proceed through the curriculum. But if med school keeps on going the way they've been going so far, and don't explain to future doctors what each of these other healthcare professionals do, "interdisciplinary health care" will just be another Utopian ideal with no manifestation in this world... another untapped gold mine.

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