"doctor" means teacher

[miriam_e]

I just looked online for some information for a friend who had a brain scan in an attempt to find an explanation for her terrible headaches. Apparently she has a lesion in her right basal ganglia. Now that area is a fairly large and complex part of the brain so it could have many possible effects. I was trying to learn more about it and found a site called Medcyclopedia. It had some tiny thumbnail images that looked like they might be of use, but unfortunately I would have to register in order to view the full-size images. I always find this compulsory narrowing of audience annoying, but annoyance turned to disgust when I found that in order to register I had to "prove" I was a professional by clicking the aortic lumen in the image presented, only to find that the page was so incompetently designed that it didn't work on any web browser other than Microsoft's awful and dangerous InternetExplorer, which fewer and fewer people use these days.

What is with medical groups that they are so loathe to disseminate information to the public at large? Don't they know that the word "doctor" originally meant "teacher"? Everywhere around the world there is a shortage of medical doctors. And the doctors themselves generally would like to be able to spend more time with their patients and less time on trivial things. They also bemoan the rise of nutty strains of "alternative" medicine, such as chiropracty or homeopathy, but they seem utterly opposed to disseminating the very knowledge which would drive back such superstitious beliefs.

Sometimes I think the medical profession is its own worst enemy.

Comments

Re: about chiropracty

[dorjejaguar.livejournal.com]

The article I read about the placebo effect said it was getting *stronger*. I don't know if you caught that, it wasn't just that it was better recognized.
There's loads of articles on it. If you google "placebo effect stronger" they show up.
In the US though drug makers have to prove that their drugs are more effective than placebo otherwise they won't be approved.
Which honestly anything that slows down the flow of drugs I think is good. They advertise them directly to us. That's legal. Now if they just had some kinda higher standard for the does harm versus does good ratio. Lots of drugs are affective for one limited thing but the side effects are really really not worth it.

I do really want to know what exactly is "popping" when joints pop. If you do find any info on that let me know. If MRIs could be done with moving bodies or xrays with moving bodies producing a sort of video then that would help. Strange that we don't have something that can do that.

Re: about chiropracty

[miriam-e.livejournal.com]

Thank you for pressing me on this point. It was one I hadn't been aware of. I just now read an amazing article in Wired magazine at

By far the most interesting response was this:

As a psychiatrist involved in Phase 2 & Phase 3 clinical trials, I have a very simple explanation for the increased placebo response: inclusion & exclusion criteria in clinical trials are becoming so strict that the patients screened and randomized are less and less sick (i.e. suffer from less severe conditions than 10 or 20 years ago). In turn, the placebo response can only be higher as it is a well-know fact that, in the field of depression for instance, the most severe forms of depression (i.e. melancholy) will have a higher response rate to effective treatment than placebo (and thus patients suffering from milder conditions will have an increased response rate to Placebo)

For instance, in 99% of the recent antidepressant clinical trials I've been involved with, patients with suicidal thoughts (one major sign of depression) can't be enrolled (for fear of legal problems in the event that a patient involved in the trial would commit suicide). Similarly, concomitant medications (such as anxiolytics or sleeping pills) are usually disallowed so many patients with severe anxiety/insomnia (other major signs of depression) won't agree to participate in a placebo-controlled trial.

I understand that it makes more statistical sense in order to prove the efficacy of a new treatment to avoid concomitant medications and of course that it is ethically hard to justify to randomize patients with suicidal thoughts in a placebo-controlled trial. But the inevitable consequence is that the Placebo response is bound to keep increasing as legal issues and obsession with "clean" statistical data keep increasing.

Added to what he mentions, I'd expect that modern infatuation with drugs would make placebos more potent. It brings me back to something I used to wonder about much more in the past... can we learn to control these things instead of having to be tricked into them? When I was at the height of my pain problems when I was a teenager my parents got me an amazing book Relief Without Drugs by an Australian doctor, Dr Ainslie Meares who learned how to control pain without anaesthetics. He proved his theories by having a dentist friend pull one of his teeth out without anaesthetic. I never became that good at it, but became able to remove most discomfort and non-acute pain simply by getting my mind into a space that is difficult to describe.

I have heard, and read, that the popping sound made by joints (for example when knuckles are cracked) is because gas comes suddenly out of solution as bubbles in the synovial fluid of the joints. I don't know how true this is, though it sounds likely to me. One of the problems boat propeller manufacturers have is cavitation. That is the name given to the little bubbles that pop out of the water as a propeller turns, and it is incredibly destructive -- the bubbles gradually destroy the steel of the propeller, each like a little hammer. Now, if bubbles in water can do that to steel, I wonder if bubbles in joints damage them? I don't know, but I worry about it.

Re: about chiropracty

[dorjejaguar.livejournal.com]

You're welcome. :)

Relief Without Drugs, that sounds interesting.
I'm not really surprised it could work. I've got friends who hang from hooks for the fun of it and I would have done the same by now except I could never come up with a good enough reason to bother. I do have some other experience with transmuting pain.
Every new pain is a new instance though and it's kinda like starting again from scratch remembering how not to mind. I taught myself how not to mind though, might be good to read someone else's thoughts on it.

The gas in the joints, where does it come from, where does it go?
Even if it is like little hammers we're not banging up against the bubbles with the frequency that steel propellers do, so I figure we can worry about it less. Also, steel is harder than anything in our bodies, and in cold water it has even less give. Our bodies are a bit more giving, which is probably good.

Re: about chiropracty

[miriam-e.livejournal.com]

Oops. I didn't give the address of the Wired article:
http://www.wired.com/medtech/drugs/magazine/17-09/ff_placebo_effect?currentPage=all

Re:

[dorjejaguar.livejournal.com]

;) Thanks.