> "Do you know what they call 'alternative medicine' that's been proved to work? Medicine." - Tim Minchin, Storm, 2008
I've been a big fan of Tim Minchin's, and thanks to living in one of the cities where he built much of his early fame, I've seen and enjoyed much of his work.
But I feel like a form of Godwin's Law should apply to this quote.
It's been done to death, it contributes nothing of value to the discussions in which it is cited, it minimises and trivialises the horrible predicament of people (like myself) who experience illnesses that mainstream medicine can't/won't recognise or treat, and serves only to promote a sense of smugness among people who think they have mainstream medical science on their side.
The point that people sharing this quote don't understand is this: For mainstream medical science to 'prove' something to work, it requires huge commercial and/or political incentives to do the research. If a pharmaceutical company or research institution can't reasonably expect a study to result in the development of a drug that can yield hundreds of millions or billions of dollars, it doesn't get done. That leads to a vast gap between what has been "proved to work" and what can actually work for people who take matters into their own hands, as I've done very successfully.
It's notable that all the comments here seeking to refute Mz's comment are doing so by exaggerating or outright misquoting what she said.
This is not true. The medical field does a lot of research which is totally unrelated to drug development. Pick up a random collection of medical journals and look for yourself.
Indeed, I neglected to mention the other main motivator for undertaking research: to be published in journals. Thanks for pointing it out.
Seriously though, can you not see how the medical research system (and most importantly, the kinds of things that will be included in studies) is influenced by the fact that any study must seek to deliver on a commercial incentive, a political one, or at the very least, be likely to published in a reputable journal [1]?
[1] Incidentally, this is also, indirectly, a commercial incentive, given that journal publications are used as a key metric for ranking research universities internationally, which has a major bearing on funding.
The point is that this qualifier - that research must be "worth publishing in a reputable journal" - imposes significant constraints on what kind of research may be attempted to begin with.
An hypothesis that is too far outside of mainstream accepted thinking may not be studied, if it seems (to the people proposing the study or the people considering funding it) like it will be too hard to get it through peer review or editorial review.
I'm not suggesting this is necessarily a flaw in the system; it is healthy that there are constraints on what kind of research gets funded, and for things that are way outside of established thinking, the bar should be higher [1].
But it does mean there will inevitably be a gap - quite possibly a very big gap - between what has been "proved to work" and what can be effective for those who want or need (like myself) to take matters into their own hands.
[1] Problems like politicisation, egotism and bullying are often said to be rife in scientific research institutions, so it's questionable whether the system is as healthy as it could be, but that's a separate discussion.
Hand wavy recollection of what a very knowledgeable cancer patient told me years ago: They were incredibly frustrated that most cancer research related to the type of cancer they had was variations on the same thing because it was the trendy thing to fund. This person was hoping for real progress, but was seeing just dozens of studies of the same thing with minor variations and nothing actually interesting or really new being done.
That could just as well be confusing cause and effect. Particular avenues of research can capture a lot of funding and become trendy because they seem most promising at the time. Hard decisions also have to be made on risk versus reward; should we shoot for the moon or target limited incremental progress? It's easy to criticize after the fact with the benefit of hindsight.
> I feel like a form of Godwin's Law should apply to this quote.
I would liken it more to the "nothing to hide" argument or "it's what plants crave." Some things actually are Nazi-like even if it's cliche to point it out. Whereas the Minchin quote is just something that people mindlessly repeat, seemingly detached from any sort of objective reality.
On the contrary, I shared this quote having full knowledge of the cost and complexity and political barriers, having both studied the industry academically and being personally close to medical practitioners engaged in the research and implementation of new treatments.
I think all suggestion of "alternative remedies" is dangerous, since it opens the door to those preying on desperation to sell false hope. I have an active dislike of the phrase, because it fails to capture just how harmful they can be, and how rarely they are actual remedies. "Unproven interventions" might be a better name.
More precisely, they also serve to mask those treatments deserving of more research that might actually have some potential, because such signal is lost in the torrential noise of snake oil and quackery.
I join your criticism of the externalities in the US market-led system that incentivise research into drugs of symptomatic relief rather than cures.
Nevertheless I believe that is a short-term systemic malfunction, and in any event is not a severe problem elsewhere where drug pricing is regulated. Large amounts of money and time are routinely allocated around the world for fundamental research into many difficult and poorly understood conditions. Pointing out that medicine can't treat everything is fine, because if it could we wouldn't need more research. But claiming the research doesn't get done, that's simply untrue.
I think all suggestion of "alternative remedies" is dangerous, since it opens the door to those preying on desperation to sell false hope.
I'm with you on practitioners who charge thousands of dollars offering to cure terminal cancer with carrot juice and coffee enemas. But this is a very small segment of the industry, and from what I've seen, anyone who does that for any amount of time gets regulated or shamed out of business.
Most natural health practice is nothing of that sort. It's things like diet/nutrition, exercise, stress/trauma therapy; all things that have significant evidence of being beneficial.
All the treatments I've tried in my journey to get well fit into this category: low-risk treatments for non-life-threatening conditions, that just support the mind and body to heal and strengthen naturally over the long term. I've been doing it for nearly 10 years and in that time my life has utterly transformed.
Do you have any objection to this that doesn't rely on dismissing every health provider without a medical degree as a dangerous charlatan?
Most natural health practice is nothing of that sort. It's things like diet/nutrition, exercise, stress/trauma therapy; all things that have significant evidence of being beneficial.
All the treatments I've tried in my journey to get well fit into this category: low-risk treatments for non-life-threatening conditions, that just support the mind and body to heal and strengthen naturally over the long term.
This has been my experience as well. MCT oil has long been medically recommended (i.e. by actual doctors) for serious gut issues, such as stomach cancer and cystic fibrosis. It is not routinely recommended by doctors as a standard treatment for CF, but it is popular in the CF community. It isn't not a drug. It is not an unproven treatment. It has a solid track record.
But, it seems to not be actively promoted in part because it isn't a drug. It is cheap and effective, but no miracle cure.
What gets actively touted are new drugs that cost $250k or more annually and are only effective on about 5 percent of patients.
There is no big fortune to be made in telling seriously ill people "If you eat better and avoid triggers, you can have higher quality of life, need fewer drugs, etc." There is a huge fortune to be made on these extremely niche drugs with insane price tags. So, doctors and other business people often promote the things that are lining their pockets, rather than the things that help patients improve their quality of life at little cost and low risk.
Nutrition. Exercise. Stress management. I think these are mainstream health practices.
There are practitioners with other qualifications. Although I've met physios with some peculiar ideas that subsequently turned out to be have a very high proportion of adverse effects (e.g. spinal adjustments).
My message is consistent, I hope: try what you will, but never pretend to expertise, and steer clear of recommending or suggesting anything to anyone, because at that moment one becomes a snake-oil peddler and are risking harm to someone else. Recognise that even medical practitioners are taught not to treat themselves or family because you cannot, cannot be objective about it.
I do not express an opinion on your personal journey, except to say that despite not knowing you from Adam it's still gladdening to learn that you are feeling better.
...except to say that despite not knowing you from Adam it's still gladdening to learn that you are feeling better.
Thanks for the constructive comment.
I would urge you to examine your own conduct in this thread however, particularly towards Mz.
You really do seem to be waging war against a straw man, and expressing fears about risks and dangers that everyone like myself and Mz are well-and-truly aware of and cautious to avoid.
I'm sure you are sincere in your belief that you are well-intentioned.
But in your quest to protect unwitting victims of snake-oil-touting charlatans, you end up being a bully towards people who have experiences and insights that you don't have, and infantilising people who are mature and educated enough to do their own research and make their own decisions.
Like I said, I'm sure your heart is in the right place. But you'd do well to be more considerate toward others' experiences and perspectives, and charitable in your reading of different opinions on issues of such importance.
Nutrition. Exercise. Stress management. I think these are mainstream health practices.
If you have a very serious medical condition, like cancer, and you talk to a doctor about things like taking vitamins, most of them will pooh-pooh it as if any impact it has is merely a placebo effect. Using nutrition, exercise and stress management as part of your defense in the face of something that doctors don't really know how to treat gets dismissed and attacked and basically lumped in with snake oil. In fact, you are basically doing this yourself with your wild misquotes of people here in service of some agenda that has nothing whatsoever to do with trying to comprehend anything being said here, as best I can tell.
Are there any specific vitamins which have been shown effective in treating cancer or other serious conditions? In general research into vitamin supplements hasn't shown any benefits, at least not for people with working digestive systems who eat proper balanced diets.
A relative was diagnosed with dementia and the doctor recommended all 3 of these things. I agree they are mainstream. Of course he's not going to say they'll cure it or cancer because there isn't evidence of that.
I am not surprised that you dislike that I have rebutted your remarks. Nevertheless, when I quote you, it is practically cut-and-paste.
Mz, I think your comments in particular in this thread have been worthy of such strongly worded reprimand because they could lead others to attempt self-treatment and to disregard medical advice.
The fact that you've done so by misrepresenting the character, motives, competence and behaviour of practitioners is something I take further umbrage at.
When you misquote me and then wildly twist my meaning, with zero intent whatsoever to actually have any respect for me or understand anything I am saying, yes, you very selectively cut and paste in order to try to make it say whatever meaning you are attempting to force upon my words.
IMO, it's an unhelpful quote because it's only useful for alternative 'treatments' that have been shown not to work (beyond placebo). It largely ignores the fairly large gray area of treatments that have shown promise but haven't been extensively studied enough to become part of mainstream medical practice. If no other treatments are available, investigating these options may be a perfectly rational thing to do (with the appropriate input from a genuine medical professional, not a random/unqualified 'alternative' practitioner).
Personally, I use caffeine, in addition to an SSRI, as an OCD treatment, based on a single, small (n=12 for the caffeine group)[0] clinical trial. Clearly the evidence isn't there to declare it a viable treatment -- it could easily be placebo[1] and/or prove to be detrimental for other patients -- but my doctor and I concluded that the risk of trialling it was close enough to zero in my specific circumstances to give it a shot. Thus far, it has provided a noticeable subjective improvement day-to-day.
(Note to any other OCD patients - I'm NOT suggesting you should try this, in part due to the anxiogenic properties of caffeine)
Of course that doesn't mean we should just throw open the doors to the various snake-oil pushers (especially where well-proven interventions exist), but IMO going too far in the other direction would also be a mistake.
[1] Something I personally doubt, as other alternative treatments (including those I have suggested) have had either no effect or worsened the condition, but of course there is no way for me to rigorously test this.
I've been a big fan of Tim Minchin's, and thanks to living in one of the cities where he built much of his early fame, I've seen and enjoyed much of his work.
But I feel like a form of Godwin's Law should apply to this quote.
It's been done to death, it contributes nothing of value to the discussions in which it is cited, it minimises and trivialises the horrible predicament of people (like myself) who experience illnesses that mainstream medicine can't/won't recognise or treat, and serves only to promote a sense of smugness among people who think they have mainstream medical science on their side.
The point that people sharing this quote don't understand is this: For mainstream medical science to 'prove' something to work, it requires huge commercial and/or political incentives to do the research. If a pharmaceutical company or research institution can't reasonably expect a study to result in the development of a drug that can yield hundreds of millions or billions of dollars, it doesn't get done. That leads to a vast gap between what has been "proved to work" and what can actually work for people who take matters into their own hands, as I've done very successfully.
It's notable that all the comments here seeking to refute Mz's comment are doing so by exaggerating or outright misquoting what she said.