As a survivor of childhood leukemia I consider myself a product of modern medicine. I was born in a hospital, grew up in a hospital undergoing cancer treatment, and now I work in a hospital. I was fortunate to spend most of my youth with a cohort of bright friends (See: Yuppity.us). We had an inclination towards academic achievements which lead many of us towards careers rooted in basic science (nursing, banking, engineering, medicine). As a result, I spent my early years in undergraduate biology developing a respect and understanding of the scientific process. Today, as a medical resident, I observe the science at work through the clinical research which influence medical practice. This basic understanding is essential to medicine. How does an idea become a treatment? How does a treatment prove its efficacy? How safe is the treatment? How does it compare to what we already know? These are all great questions which are readily answerable by via multi stage clinical trials which is an adaptation of the scientific method.
Clinical treatments are born through research and discovery. Therapies undergo strenuous testing and peer review followed by further experimentation to determine adequate dosing schedules and methods of administration. Only then does the medical community accept a therapy into practice while hopefully accounting for long term side effects as they follow a cohort of patients. Anyone familiar with modern healthcare has a general appreciation for the immense and rigorous testing each new therapy is subject to. The confidence that medical professionals have with researchers and pharmaceutical companies is based on the meticulous standards that are in place. Physicians are expected to understand the breadth of medical therapies, apply them to clinical practice and explain just what the hell they are doing to each of their patients. It isn’t the job of the patient to know about phase II clinical trials, or the cost of drugs, or the pathways in which the medication works. There is, however, a trust between the two parties that serves as the elemental basis for the relationship. Often times, this matter of trust comes into question. The patient physician alliance is sometimes at odds as a result of ignorance, confusion, or downright mistrust of the medical system.
In the prairies, where I trained in medical school, there were certain groups of less educated patients, as is often true for every patient population. One group consisted of blue collar or farming individuals, who for the most part accepted modern medicine and were happy to follow healthcare recommendations or have open discussions. The other population consisted of Native Americans in the area, who had difficulty with medical education and compliance. This is partly due to longstanding social issues, and mostly due to understandable distrust of white culture in general (part of a much bigger discussion). Who I found really interesting were the Hutterite people. Despite their inclination towards simplicity, modesty and rejection technology they always maintained a profound respect for modern medicine. They were some of the most compliant and grateful individuals. They were able to disregard their technophobism when the health of their family came into question.
I have since moved to the west coast, and over the last year I have witness a host of new populations and issues around patient ignorance and physician trust. Some of these are understandable – cultures that have roots in traditional medicine, individuals with language barriers, and issues with access to care for lower SES populations. However, I have found that most patients are more than willing to have a discussion and at least consider a medical opinion, especially in the realm of oncology. I have, however, become increasingly aware of a more menacing form of distrust and ignorance; which has emanated from a specific group of individuals. For the sake of discussion I’ll refer to them as the “Whole Luddite Society”.
To understand this group I’ll try and characterize what they are all about.
Whole Foods: the “green cathedral”. It’s the consumer nexus for well-to-do yuppies and health conscious folk everywhere. It is the best place to obtain organic fruits and veggies, gluten free baking, and homeopathic concoctions for sensibly outrageous prices. I kid … Whole Foods does offer some legitimate perishables. However, it also boasts misleading and dangerous foodstuffs alongside their pledge for everything organic, natural and healthy. I think Whole Foods serves as a great parable for understanding the mindset of an average Whole Luddite. So let’s dig a bit deeper.
At Whole Foods microwave dinners, preservatives, pesticides, and artificial additives are looked down upon as non-healthy. Some of these claims are legitimate. Yet, homeopathic remedies, which are emphasized as part of their holistic mantra, are thought to be a sensible and sometimes essential method of improving personal health. Never mind the fact that homeopathy has been relegated to utter nonsense by the scientific community. It has been aptly referred to as “placebo therapy at best and quackery at worst”. Homeopathy is pseudoscience in sheep’s clothing. To the Whole-Luddite, the aisles that consist of homeopathic remedies are a surrogate for the pharmaceutical isles in Safeway or Wal-Mart. This resemblance is dangerous. Real science has is being shoved out. It’s an allegory for the degree to which nonsense has invaded the mindsets of the Whole Luddite.
For the record, I know these are gross overgeneralizations. However, you-would-be-surprised. I understand that most of these choices are considered to be personal decisions, and if people want to spend most of their pay check on worthless junk then why should I care? The real issues arise when society as a whole is affected; when healthcare, children’s health guidelines, and public policy begin to amend their practices because of the whims of the Whole Luddites. Vaccination naysayers, naturopathic prescribing rights, home birthing, gluten intolerance, adrenal fatigue and hundreds of medical anecdotes are a direct result of the Whole Luddite Society pressing their agenda of pseudoscience onto society at large. When Whole Luddite rhetoric filters down to the general population this influences the doctor-patient relationship in some tangible ways. A family physician does not have adequate patience or time to convince a parent to vaccinate their children. An oncologist doesn’t have the resources to chase down a patient who would rather pursue alternative therapies, whilst missing the window of opportunity to achieve cure. Worst yet, a hospital cannot convince a high-risk mother to birth in a medical centre when she is persuaded to deliver in her own home.
The mindset of pseudoscience is fundamentally irreconcilable with the medical community because it undermines the foundation of evidence based practices. It obliterates the means for meaningful communication between both parties. While Whole Luddites are at times placing their own well-being at risk, their growing prevalence poses real risks for the general public (remember the recent Dr. Oz fiasco?).
Young children and the elderly are affected by losses in herd immunity (measles outbreak in Vancouver!). Late diagnosis as a result of naturopathic mismanagement leads to larger medical costs down the road. Significant payments for alternative therapies leave many families financially burdened. Unfortunately, some of these lessons can only be learned once. All it takes is one home birth gone wrong, one missed diagnosis and one tumor becoming metastatic for the cost of pseudoscience to become intolerable. Believe me, I have personal witnessed all of the above scenarios.
Members of the Whole Luddite Society are generally learned and successful, often young professionals. Society can’t afford to have them led down a path of bamboozlement, squandering their ingenuity and smarts. It is the responsibility of educated individuals to support good public policy and disseminate the truth. The same people who often gawk at climate deniers can’t in the same breath preach anti-vaccine rhetoric; they have fallen victim the same fallacy.
Bad science is just bad science. Bitch.