Remembering the Barefoot Doctors

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gmattson
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From a inquisitive layperson. . .

Post by gmattson »

Thanks Bill and Ian for some very excellent advice that is pretty easy to understand but very difficult to follow.

However, in defense of 'placebo' therapy, be it sugar pills, blessed water or healing hands. . . I was very happy to read Ian's words supporting what I consider to be an important part of healing. . .

"not to discount our own body's ability to heal itself". Some people have this ability to activate this mechanism on their own. Most others, need some kind of outside 'nudge', due to a lack of confidence or belief and without this outside jump-start, would not be able to use this internal healing mechanism.

I know the AMA would never endorse such a program, but what would it hurt to have the doctor working with a "healer" (for want of a better term) who tries the alternative (much lower cost option) methods either as a first line of defense or in cooperation with what is considered by the AMA as state of the art medicine.

Wouldn't hurt anyone - might work - and the MD could take credit for the cure, be it placebo or $80,000 cocktail!
GEM
"Do or do not. there is no try!"
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Post by IJ »

Folks--

GEM, I'm right there with you, and not alone; there was an acupuncturist who worked in my office in the Fenway. I don't have to believe he's better than placebo to believe he's great at satisfying patients and making them feel better. I wish I always could!

Bill: I would give you plenty of credit for your health. Any sane person would. There are those with bad luck no matter what. It's part nature, part nuture--but we should focus on what's under our control, for sure. Too many also forget that "healthy" and "absence of disease" are totally unrelated.

All: I wrote a lengthy review of the homotox site, its journal, articles in the journal, and citations used--Bill might have been interested. Sadly the computer logged me out as I worked for an hour and it's GONE. In any case, the site and the journal are basically dressed up ads for herbals products without safety or efficacy data :(
--Ian
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Post by Ted Dinwiddie »

THIS thread is why I love this forum. Thank you to all the civil, intelligent, and earnest participants.

Bill, I'd like to use as statement you made, with attribution of course:

"Secret science is an oxymoron"
ted

"There's only one basic human right, the right to do as you damn well please. And with it comes the only basic human duty, the duty to take the consequences." - P.J. O'Rourke
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Post by f.Channell »

Chi is one of those things I have trouble discarding.
You can't see it, you can't measure it, people tell you it's there. They can't prove it.
Reminds me a bit of God or a Holy spirit.
I'd hate to be wrong about it, so I'm not going to say it's not there.

F.
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Post by Bill Glasheen »

f.Channell wrote:
Chi is one of those things I have trouble discarding.
Why? If it can't be defined or measured, then it's of no use. If I can do things that the chi-sters can do without any claim of chi, then it's of no use. If a chi-ster can't hold the pisspot of a mixed martial artist in the ring or stop bullets on the battlefield, then it's of no use. If nobody can win The Amazing Randi's one million dollar challenge to prove its existence, then it's of no use.

Leave it for the Hari Krishnas to worry about. They need the magic.

- Bill
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Post by IJ »

Wow Bill, that one is gonna haunt you if we get back to religion someday! :)
--Ian
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Post by Bill Glasheen »

Not at all, Ian. The most important thing I learned with my Judeochristian training is what I do and not who I associate with.

I'd rather look around me -- compose a better song
`cos that's the honest measure of my worth.
In your pomp and all your glory you're a poorer man than me,
as you lick the boots of death born out of fear.
I don't believe you:
you had the whole damn thing all wrong --
He's not the kind you have to wind up on Sundays.


Jethro and I get it just fine. 8)

- Bill
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Post by IJ »

Let me rephrase then--you seem to be more blunt about some unverifiable beliefs and charitable with others. Not that there isn't an obvious and reasonable cultural explanation for that...
--Ian
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Post by Bill Glasheen »

IJ wrote:
Let me rephrase then--you seem to be more blunt about some unverifiable beliefs and charitable with others. Not that there isn't an obvious and reasonable cultural explanation for that...
Nope... I see the subtle wisdom in Jefferson's Virginia Statute on Religious Freedom. Read it very, very carefully.

The essence of Judeochristian teachings isn't in the institutions or even the dogma; it is in the way you conduct your life. The essence of TJ's Statute is that YOU don't get to tell me how.

- Bill
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Post by IJ »

I share with you the occasional mistake that if someone has a difference of opinion with me, they must be suffering from a touch of ignorance or be in factual error :) It is not always the case. I have read the act,

http://www.vahistorical.org/sva2003/vsrf.htm

and it has no bearing on the issue I referenced. If you recall, Carter was critiqued here for being wishy washy on adultery by saying he'd sinned in his heart but not actually, and my response was my biggest concern was the endorsement of supernatural beliefs by the former President of the USA, most powerful nation in the world. I got canned for that because it was impolitic or impolite, or something--and reminded the original text* referred to the actual planning stages and not mere interest as is unavoidable under the influence of testosterone. I wager that if I'd said,

"If it can't be defined or measured, then it's of no use. If I can do things that the Christian can do without any claim of Christianity, then it's of no use. If a Christian can't hold the pisspot of a scientist in advancing knowledge, or pray away bullets on the battlefield, then it's of no use. If nobody can win The Amazing Randi's one million dollar challenge to prove its existence, then it's of no use."

the reaction would have been even stronger than it was. None of this has anything to do with the rights of all of us to believe in Christianity or other religions or chi, or to express those beliefs--that was never in doubt. That leaves the only part of the religious freedom act which may be relevant to be his first paragraph where he uses vague religious terms to establish the rights of mankind. Jefferson and religion is an interesting and complex subject (google the Jefferson Bible or review some juicy quotes here: http://www.nobeliefs.com/jefferson.htm ) but rather than go into details I think it's an appropriate time of year to comment on the Christmas observance of my father, whom I've grown to admire in a sort of Mark Twain kind of way.** He thinks the supernatural component is highly unlikely, thinks the emphasis on purchasing and excess would have horrified the guy we supposedly honor, knows that Christmas trees are a co-opted pagan ritual and is well aware that Christ wasn't born around Christmas, BUT admires much of the ethics and has therefore volunteered several days a week since retirement with Habitat for Humanity (as a carpenter, no less), and asks each year only for a donation to a charity. Plenty of time remains (if you want to keep an arbitrary deadline) and join me in some Christian Christmassing:

http://doctorswithoutborders.org/donate/
--This year's choice, highly rated by charity monitors and ta-da, winner of the Nobel Peace Prize just like our President

http://www.habitat.org/support/
https://american.redcross.org/site/Donation

*but not the available TRANSLATION which many people go on and belief in which is on equally valid grounds
**“When I was a boy of 14, my father was so ignorant I could hardly stand to have the old man around. But when I got to be 21, I was astonished at how much the old man had learned in seven years.”
--Ian
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Post by Bill Glasheen »

I don't see the parallels with chi and religion, Ian.

Most religions of the world can be summed up with three basic components:
  • The Golden Rule
  • Dealing with our earthly mortality.
  • Concerns about the origin of the Universe
Chi as it is described in the west is a badly-translated word that describes many things in Chinese culture and meridian-based Chinese medicine. It has nothing to do with ethics, (im)mortality, or the origin of the universe.

If you want to worry about the presence or absence of a supernatural being, well knock yourself out. I don't lose any sleep over it. I can live with it, and I can live without it. So you won't bait me into a debate over the issue.

If you wish to impose your beliefs on others about things that are improvable, well then I'll call on Mr. Jefferson's wise words. I support freedom to practice the religion (spiritual beliefs) of your choosing - including atheism. And I support the concept of freedom from others' views on religion, god and/or the lack thereof.

As a medical practitioner, you'd be lost without patients' personal beliefs about The Golden Rule, the afterlife, and the power of positive thinking (a.k.a. prayer). You are unwise not to support practices where they provide real outcomes and/or personal comfort to the patient.

Coming to terms with the afterlife before you meed The Grim Reaper in some dark alley is also a very wise thing to do. See Grossman, Laur, and others. Hesitation can be a very bad thing when your life is on the line.

I'm just sayin... ;)

Go join a Christian, Jewish, Muslim, or Hindu friend and sit in on their service some time. Empathy is a wonderful thing. And understanding the spiritual beliefs of others can go a long way to you helping guide the misguided when they wish to do harm to others in the name of religion.

- Bill
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Post by f.Channell »

If chi is something you can't see or measure or prove or disprove then it is very comparable to Religion which has the same attributes.

Is the spirit which leaves the body at death "chi." For those who believe in such things.

Early Christians such as Gnostics, Nazoreans, etc were all about the spirit.
You had no mortality because your spirit was trapped in a living corpse.
Could it be the chi which is the spirit?
That got changed to good works to fill the coffers by the Pre Orthodox Catholic Church. Many Protestant groups such as Puritans did not buy that.

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Post by IJ »

Chi is not religion, and I wasn't indicating it was. But it is a belief in something unmeasurable and unproved, and represents a theory for which there are more plausible alternatives. In this, it is very much like religion. Am I trying to "bait you" into a debate about the existence of God? No, but I was pointing out that you point that scientific light more strongly at Chi than at religion. I think that does matter... there are reasons to have a consistent approach in their logic, and to endorse that kind of thinking, and I think if everyone applied a little skepticism to all of their thinking, we would see less errors of certainty, whether they be an unshakable belief that God wants you to blow something up, or my friends opinion that my Prius battery will need to be replaced in 5 years or that "The Fourth Kind" was partly a government documentary project about alien abductions.

As far as worry over the presence of the supernatural, well, it makes sense to do this. Miss out on choosing the right one and you could miss out on eternal paradise, I'm told. I'd expend at least as much energy on that as I would debating chi.

As far as imposing my beliefs on others? Whoa, nelly. Maybe you're being hypothetical here, but I certainly don't endorse depriving anyone of their freedom to practice Mormonism, chi gong, or you name it. And I don't go berating Mormons or chisters at parties, but I won't be found expressing enthusiasm for either nor suppressing my beliefs when asked--especially since the Mormons don't believe in that freedom to practice the way you and I do. That makes me endorse "Under the Banner of Heaven," more often than, say, "The Omnivore's Dilemma," although both were good reads.

I would be (is that future conditional?) unwise to deprive my patients comfort, so I'm sure you're pleased (I hope not surprised) to learn that I do nothing but encourage and respect patient and family preferences (which I ask about nonjudgmentally) with regard to the intersection of religion and healthcare. More than even many nominally religious colleagues, I ask people about their beliefs and refer them to the appropriate priest, minister or rabbi at appropriate times, and I tend to stay with the sick and dying and support families through the end, often as the priest etc does his or her job. Most doctors write for the morphine drip and don't check in until it's time to pronounce. Last time I did this: 3 days ago. I'll also never forget praying with a 96 year old woman in clinic who was awaiting hospital transfer and telling me she had no remaining friends or family and was alone except for God.

I should clarify that while i don't discourage (and rather, encourage) practices patients find comforting, I also don't encourage them to develop religious or other nonevidence based beliefs (such as that their leukemia can be prayed, denied, or supplemented away). There's definitely no data for that, NOR is there data that religious belief is more comforting than other systems for approaching illness or stressful times, AND we do know that intercessory prayer is ineffective--it's been studied.

You may be also interested in the idea that intercessory prayer is about as unchristian as it gets in the usual sense. The very idea suggests that those lucky enough to have family, and especially fame, and therefore receive more such prayers, are going to have better outcomes than the poor, unknown, and unlucky, the traditional subjects of Christian charity. People who believe that God goes on merit or need instead of prayer count or intensity find the idea maybe a bit repellent (if they've considered it). When I first heard about this reasoning, it wasn't from an atheist, but a minister couple, who gave me a book by Bishop Shelby Spong (then they offered to marry me and my partner and risk losing their connection to their church which forbade the practice--super nice, but had to decline!).

So, instead of prayer, send cash (or clothes, food, effort). See previously posted links!

Neologism of the day: just like there are theists, there are achiests. I know at least two ;)
--Ian
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Post by Bill Glasheen »

f.Channell wrote:
If chi is something you can't see or measure or prove or disprove then it is very comparable to Religion which has the same attributes.
Religion is real, concrete, measurable, and in some cases quite useful. Chi is not.

God? Another story altogether.

- Bill
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Post by Bill Glasheen »

IJ wrote:
I was pointing out that you point that scientific light more strongly at Chi than at religion.
No I don't.

This is just one example. I could cite many, many such publications which pretty much say the same thing - religiosity is useful.

Lots of this kind of work is going on south of me at Duke University.

- Bill
Relationships between the Brief Multidimensional Measure of Religiousness/Spirituality and health outcomes for a heterogeneous rehabilitation population.

Johnstone B, Yoon DP.

University of Missouri-Columbia Center on Religion and the Professions, Columbia, MO 65212, USA. johnstoneg@health.missouri.edu

PURPOSE: To determine relationships between the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS; i.e., positive/negative spirituality, forgiveness, religious practices, positive/negative congregational support) and physical and mental health (Medical Outcomes Scale-Short Form 36; SF-36) for individuals with chronic disabilities.

RESEARCH METHOD: A cross-sectional analysis of 118 individuals evaluated in outpatient settings, including 61 with traumatic brain injury (TBI), 32 with cerebral vascular accidents (CVA), and 25 with spinal cord injury (SCI).

RESULTS: Three of 6 BMMRS factor scores (i.e., positive spiritual experience, forgiveness, negative spiritual experience) were significantly correlated with the SF-36 General Health Perception (GHP) scale, and only 1 of 6 BMMRS factor scores (i.e., negative spiritual experience) was significantly and negatively correlated with the SF-36 General Mental Health (GMH) scale. BMMRS scales did not significantly predict either physical or mental health in hierarchical multiple regressions.

CONCLUSIONS: Positive spiritual experiences and willingness to forgive are related to better physical health, while negative spiritual experiences are related to worse physical and mental health for individuals with chronic disabilities. Future research using the BMMRS will benefit from using a 6-factor model that evaluates positive/negative spiritual experiences, religious practices, and positive/negative congregational support. Interventions to accentuate positive spiritual beliefs (e.g., forgiveness protocols, etc.) and reduce negative spiritual beliefs for individuals with chronic disabilities are suggested.
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