Monday, April 8, 2013

I am wrong

This is, in part, a public apology to my partner who is many many time zones away from me at the moment.

My partner and I have had a discussion about placebos for a long time. I have always argued that, in a sufficiently resource constrained environment, where access to medicine and medicare is sufficiently limited, giving a patient a placebo for an ailment that they could not get a better cure for otherwise may not be a bad thing.

My partner has always argued that, no, this is not a morally correct thing to do. It corrodes faith in the medical institution. If a doctor is willing to lie to you about somethings, how do you trust him about others? If going to a homeopath or acupuncturist or ayurved is acceptable in some circumstances, then how do you encourage people to go to MDs in other circumstances... you just increase the public health problem.

My point of view has been fed by a desperate urgent need to believe that something, ANYTHING, could help the situation of friends and friends of friends living in rural parts of my favorite third world country. Over the years, I have come to see that it would actually help my friends more to spend the money they would otherwise spend on a non-medical pill perscriber to get help around the farm for a day or two so they can rest, or to spend the money on nutrition over a longer term.

And then... Of course there's an and then.

I'm ashamed to admit it, but I did not really come around to seeing or understanding exactly what my partner was trying to say about the breaking of trust in medical authorities until it happened to me. I've been suffering from set of mildly annoying, but very rarely dangerous set of conditions for the last several months. I decided to get it checked out at the doctor's. She was very helpful, in spite the language barrier, and gave me an idea of several possible causes, did some tests, and gave me follow-up instructions. So far so good. I leave the office happily with a prescription and a referral.

Being the child of MDs, with a pharmacologist in the family, I am curious about what medicine is prescribed to me. I love poring through WebMD, and MayoClinic, and Wikipedia trying to learn about the pathways through which the various chemicals about to be coursing through my veins will effect my physiology. The more graphic the information I get about my inner workings, the more excited I get.

So... the first thing I do when I get to my office is google the name of the drug I just bought at the pharmacy. And then I walk it over to an colleague to make sure Chrome translated everything correctly. The contents of the little bottle in my hand are 25% alcohol. The rest is herbal essence and things to make sure it doesn't upset the stomach. Its an anthroposophic treatment*. Its a I feel like I've just paid a visit to a snake oil trader, a remnant of a world the FDA got rid of in the US a long time ago.

I am all for keeping mental health/spirituality concerns in mind when dealing with a patient. I am very grateful to the doctors that I had in college that spent a long time talking to me about my concerns and fears about things happening to my body. If I need more time and a GP can reasonably provide, or more trained in balancing my spiritual needs with my physical needs, I seek out a religious leader or a therapist. I do NOT turn to a bottle of alcohol.

Sigh. I am sorry for not understanding my partner's point. I am ashamed that it took something happening to me for me to get ti. This is the second bad experience I have had in this country with doctors. I am at this point, a little afraid to go to a third.

*This is also the medical movement at the bottom of the anti-vaccine movement. See this blog for more info.

1 comment:

  1. I don't know in which country you live right now, but from my personal experience with doctors in Germany I have some suggestions: first, try to avoid doctors that have the word "Naturheilkunde" (naturopathy) on the sign of their practice. It's not necessarily the same as homeopathy or anthroposophic medicine, but I found that such doctors are often prone to try and push you in that direction. And: tell your doctor explicitly that you don't want homeopathic or anthroposophic treatment. Things worked fine for me after that...