Skepticism about science and medicine

In search of disinterested science

When doctors can’t tell you what’s wrong (updated)

Posted by Henry Bauer on 2013/11/22

Some number of people feel ill, and they have no doubt that they feel ill, yet their doctors claim to find nothing wrong with them.

Not uncommonly, the medicos will infer that “it’s all in the head”, and prescribe tranquilizers or placebos or the like. Sometimes they pretend to know what’s going on and offer a diagnosis that sounds technical and knowledgeable, like “irritable bowel syndrome” or “chronic fatigue syndrome”, but offer similarly non-specific treatment: sedatives, placebos, “avoid spicy foods”, “get plenty of rest”, etc.

On TV, House featured a doctor who specialized in diagnosing difficult cases, obscure conditions. In real life, it may be that patients need to do the work for themselves.

This blog post was stimulated by the experience of a friend’s daughter, “N”, a highly intelligent, capable, productive lawyer, who had began to experience episodes of pain, seizures, mental confusion. Local doctors couldn’t help. The renowned Mayo Clinic was also unable to diagnose and cure. So N herself researched the literature. The upshot is that she suffers from a very rare disorder, Hashimoto’s Encephalopathy (eventually confirmed at the University of Illinois Medical Center in Chicago), about which there is the typical official inconclusiveness: Does it really exist? What symptoms define it? Are there effective treatments?

Hashimoto’s Encephalopathy is also known as Steroid Responsive Encephalopathy Associated with Thyroiditis or Autoimmune Encephalopathy — illustrating again the essential uncertainties about this. People who believe that they may have this condition can now turn to a patient-organized website  which is about to publish a book of case studies, personal accounts, and relevant scientific papers.

The wife of an acquaintance of mine, another lawyer, “T”, also enormously productive, came down a few years ago with what seemed like chronic fatigue syndrome. Again the official medical route did not bring help. Eventually T and her husband decided that the problem was Chronic Lyme Disease. Again there is controversy: Does this condition really exist? Doctors who have treated such patients with very long-term courses of antibiotics have sometimes been excoriated by the medical profession or even charged with malpractice — see Medicine isn’t science — nor should it be.

Even with comparatively well-defined conditions, it behooves us to take responsibility ourselves for evaluating what our doctors tell us, by getting as much other information as possible. An example that I’ve noted before is M. Aziz’s research on vitamin D (Evidence-based medicine? Wishful thinking).  After all, most doctors only know what official sources and drug companies tell them, and that has become increasingly untrustworthy  — see e.g. “Don’t take a pill if you’re not ill”, “Everyone is sick?”, and the several posts on this blog about statins and cholesterol.

Drug-based medicine is inescapably medicine for profit. No matter their propaganda and spin, pharmaceutical companies are motivated first and foremost by the need to make profits. They want to sell as much as possible at as high a price as possible, and therefore pay little attention to rarer conditions or to medications that would be used only for short periods, like antibiotics. They are on the lookout for “blockbusters” — drugs that people can be persuaded to take lifelong, like statins, anti-arthritics, breathing helpers for asthmatics and COPD patients, and most recently vaccines, which can potentially be administered to everyone (Deadly vaccines; Beyond Belief: Deadly vaccines for Africa and Asia).

Many people do in fact take responsibility when they make us of “alternative medicine”, but the same caution is called for here, because most vitamins and other supplements are described and sold by individuals or companies who make their living from such sales. There are not many disinterested sources of information about alternative medicine. One such resource, an attempt to evaluate in an unbiased and evidence-based way, is Alternative Medicine — The Christian Handbook by Dónal O’Mathúna (research chemist) & Walt Larimore (MD), Zondervan (2001, updated 2006, Kindle ed. 2010).

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