Recently, a new study showed the inefficacy of gingko biloba as a treatment for mental decline related to aging. Since my mother uses this, I was interested in this news, and posted a link on Twitter to Science-Based Medicine’s article on the subject. I received a very surprising response from another chronically ill person who self-describes as a skeptic, and who I considered to be a critical thinker. This response included an explosion of offense at this story, ad hominem attacks on both the site and Dr. Novella, and when I tried to remove myself from the onslaught, emotional leaps to conclusions that I was mocking or disrespecting this person because I declined to continue the “conversation.”
I’ve written before — and I will certainly write again — about the particular vulnerability of chronically ill people when it comes to considering complementary and alternative medicine (CAM). It’s why quacks target us, and why they are so often successful. As you know, I’m a strong advocate for people with long-term illnesses hanging on to their critical thinking skills, as hard as that is through the daily fatigue, pain, and sickness.
Many of us, however, do have blind spots in our critical thinking. We rely on certain treatments that may not be proven to the complete satisfaction of the medical community — and we don’t care, because they work for us. As I’ve said in the past, with the exception of homeopathy to which I will not give a pass, as long as the treatment causes no harm and the patient is informed and not going broke, then I’m not sure it’s my place to argue with what may work for someone. For one thing, I have a pet CAM of my own, and I am more than willing to admit my strict rules about this stuff break down a bit when it comes to this treatment. It’s another story for another day, but my point is that everything I say in this post applies to me as well. By no means am I trying to imply I’m above all this; I struggle with it constantly.
If you are going to invest financially and emotionally in a treatment that doesn’t have the support of the medical community, you also have to be self-aware. You must realize that there is an irrational component to your attachment, and you have to compartmentalize it. There are certain medical blogs where I simply won’t read stories about my own pet CAM, because I know I’m likely to get annoyed. Why? They are science-based and the science isn’t all there yet, and there is also a certain bias against this treatment in some circles. I realize that if I’m trying to research this subject thoroughly, I should also look elsewhere for other points of view.
But what I don’t do is then fault the people running these blogs because they don’t agree with me. I can’t help but find it the height of arrogance to label doctors with years of clinical and/or research experience, who are dedicated to the scientific investigation of medical claims, “stupid” because they focus on the science. I may disagree, but that doesn’t make their work invalid. My experience as a chronically ill, critically thinking layperson includes an enormous amount of personal data as well as anecdotes from many people (including my own GP) about the efficacy of my treatment. That does not change the fact that in science, anecdotes do not equal data. Just because you are firmly convinced, and even if you came to your decision through an analytical pathway, your personal experience does not change the way traditional medical science works.
If you think a legitimate study on your pet CAM is utter crap, fine. But don’t be shocked when evidence-based sites don’t support your assertions. Science-based medicine is that, and it has a right and responsibility to reject treatments that have not yet been vetted. Avoid places that you know aren’t going to support it, if you are too emotionally invested to read valid criticism, rather than trashing the science-based sites for being, you know, science-based. Or even better, bring your knowledge to those sites and join the discussion, if you are able. Looking back at that SBM article, I’m interested to note that the person I mentioned did not do so, but rather took anger and frustration out on me, the messenger. I can assure you this is not productive, except to provide me with blog fodder.
