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Comic that I am, I always imagine, the question "What kind of a doctor are you?" as a rhetorical one, in an emphatic, accusatory tone, as in "What kind of a monster are you?!" This time, it turns out, I was right.
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My daughter, both of whose parents are naturopathic doctors, when she was at the University of California at Santa Cruz, that hotbed of leftist politics, complained, "My friends are all revolutionaries, but they completely believe whatever their doctor says."
Medicine is the most unscientific science. The US Government Accounting Office states that only 10-20% of medical practices have ever been shown to be effective. (Surgery is not medicine. Surgery is a separate art.) That's hard to believe, until you consider that antibiotics have never been shown to lessen the severity or duration of an earache. Buyer beware.
My ex-wife's uncle was Medical Director of Cedars of Lebanon Hospital for 27 years. Thirty years ago, while we were visiting her folks in southern California, Uncle Harold came over. Medical Director is the top dog, the head of both sides of the hospital, medical and business. Twenty-seven years is a dynasty. Uncle Harold was a big man, a philosopher. Sitting there in the living room I ventured, "It seems to me that medicine in the last 25 years has been a two-sided coin." "Yes?" he asked encouragingly. "The major advances have all been do to better technology." "Yes," he concurred readily. (I didn't itemize for him, but I was referring to soft tissue imaging [MRIs], colonoscopies, instant blood analysis, et al.) "On the other side of the coin, our actual understanding of medicine [which is to say disease] has progressed very little, you might say, not at all." Again he agreed without thought or hesitation. In the 30 years since that chat nothing has changed.
Virtually all of the improvement in health during the 1900s was due to hygienic measures, not medical advances. (The Mirage of Health, Rene Dubois) Indoor plumbing, arguably benefits our health more than all of medicine combined. When you had to go down the street to fetch water and carry it up the stairs, people didn't wash their hands very much. When you had to go down the street and pay money to take a bath, most people didn't or only did so on special occasions. The institution of the eight-hour work day was a great boon to people's health. Exercise is the best way to prevent heart attacks. Diet is the best way to lower cholesterol, etcetera, etcetera.
Follow the money. Pharmaceutical companies contribute to medical schools, and so determine what kind of medicine gets taught. The sicker you get, the more money they make. My bumper-sticker would be, "Resist the Medicalization of Life."
The way standard, allopathic medicine gained dominance, in the early 1900s, over its other less pharmaceutically oriented cousins, including naturopathy, can be summarized very efficiently under the rubric "unfair trade practices." (Divided Legacy, Harris L Coulter) The AMA gained control of state licensing boards, and through them medical schools, by instituting criteria which are clearly not in the public's (or medicine's) good. (Late in the 1900s chiropractors successfully sued the AMA for monopolistic practices.)
Homeopathy, the scientific application of the minimal dose, arose largely in response to the unscientific administration of large doses of often poisonous drugs; Mercury kills bacteria, gonorrhea and the strep in little Johnny's sore throat. In the early 1900s, doctoring was still deservedly a largely disreputable profession. Mark Twain opined, "We can thank the homeopath for making his allopathic brethren stand up on their hind legs and learn something about medicine." The medical ethic, "First, do no harm," exists, because, indeed, a great deal of harm is done.
The licensing of naturopathic doctors survived in seven states, and, has in the last three decades, been revived in a dozen or so more. "Naturopathy" is an umbrella term, covering natural methods of treating people: acupuncture, homeopathy, herbs, nutrition midwifery and many more other modalities are included.
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Although my most important mentors were MDs, no, I myself am not. I am an ND. Some people, like the person who wrote me the emails, only believe in RDs, "Real Doctors," that is, MDs. (Believe it or not, I've never wished I were an MD; MDs practicing alternative medicine risk penalties for not following the "standard of practice" of their profession as dictated by their licensing boards.)
Just yesterday, reclining aside the lily pond at Escondido Place, a father told me how his son wound up in jail, adding, "It was so unjust." I commiserated with him, "Patients would come to see me and tell me, 'My friends think I'm crazy for coming here.' I'd tell them, 'I can tell you something about your friends.' 'What?' 'They've never been sick.' 'That's true.' 'If you have never been to court, you can believe that the justice system is about delivering justice. If you have never been sick, you can believe that doctoring is about getting you well.'" People like to believe.
When I was in my third year of medical school in northern California, I went with my housemate and her 18 month old child with cystic fibrosis (CF), to see his doctor (his last name was Lippo [sp?]) at Oakland Children's Hospital. This doctor, an international authority on the pulmonary aspects of CF, said that if the child got over the infection in his lungs, he'd gain ten pounds. I waited for an appropriate moment and asked, "Does it take that many calories to fight a lung infection?" "No," he responded, fully aware of how many calories it takes to fight a lung infection, and continued, "I've seen it happen hundreds of times and I have no idea why. There is an awful lot going on inside the body and we have very little idea what any of it is."
Calling a doctor is like calling a lawyer or the police; it should only be done in desperation, after you've every possibility of solving the problem on your own. I used to tell my patients, "Stay away from doctors... including me."
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"Doctor" means teacher. It is the same as the root of the word "eDUCation," to lead. I do, as my email correspondent accuses, refer to myself as a "scholar" (Jewish and otherwise). In fact, of all the praise I give myself, the best is that I am a good student. The rabbis (of whom, despite my email correspondent's accusation, I have never claimed to be one) tell us in the Talmud, "I have learned much from my teachers, more from my colleagues and most from my students."
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