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Newsflash: People Are Weird
“Susan” is a very pleasant 51-year-old patient of mine – very tan, fit, and beautiful. She and her husband have done well, and they have multiple houses and boats and very nice cars and such. She started to feel poorly, and called her yoga instructor for advice (Recall that I run a concierge practice, so she pays big money to have me available to ask questions. But no – she calls her yoga instructor. Anyhoo…).
Her yoga instructor recommends a chiropractor who sees her, orders labs, and on follow up reviewed the 32-page lab report with her. It was all hormones, cortisol levels, inflammatory markers, and such – nearly all of which I’d never heard of. Performed by a lab I’ve never heard of. Just the estrogen report was four pages long, with groups and subgroups of estrogen varieties, which I’d never heard of. He started her on several organic all-natural hormone combinations which I’d never heard of. When she felt no better, he started her on iron for her fatigue. I asked, “He’s treating fatigue with iron?” She said, well, not exactly – he gave her capsules with frozen organic bovine liver. “Of course,” I say.
She shows me the dazzling multi-colored 32-page lab report, and her bag of supplements, vitamins, and hormones. I ask how she’s feeling, she says maybe a little better, but still lousy. I check one page worth of basic labs, and find her hemoglobin is high. So is her iron. So are her liver function tests. The doctors who are reading along are probably nodding their heads right about now…
I ask if anyone in her family ever had liver disease. She says her brother died of cirrhosis at 39 years old, but he drank a lot. I ask her if anyone ever mentioned hereditary hemochromatosis. She says she’s never heard of it. I tell her that I think she has it, and I’m sending her to a Hematologist, who will probably do periodic phlebotomy, and she’ll feel better soon. Her face lights up and says, “My Mom did that! I forgot!”
I just look at her. Finally I say, “Look. Your chiropractor is giving you the wrong drug. To treat a disease that you don’t have. And in doing so, he’s intensifying the disease that you do have. That’s like a trifecta of incompetence. If he was a doctor, I’d report him to the state boards. This is bonkers. Let me fix this. You’ll feel better soon. The liver damage you’ve sustained probably won’t get better, but we’ll try to prevent it from getting any worse. Please. Let me fix this.”
She frowned, and asked, “If I stop seeing him, can you refill all the hormones he gave me?”
Me: “You mean the ones that aren’t helping you? No. I won’t refill those.”
Her: “Ummm… I’ll talk it over with him on our next visit.”
Me: (pause) “Right. Ok. But please go see the specialist I’m sending you to, ok? Once your liver starts to fail with hemochromatosis, it can go bad very quickly. Don’t screw with this. Don’t die of something stupid.”
Her: “Ok, I’ll go see him. Thanks.”
“Mark” is a close friend and college teammate of mine who lives in Chicago. His neighborhood is a crime-ridden cesspool. Mark has voted Democrat his entire life. And he continues to do so.
I find both of these odd cases to be completely inexplicable. Neither “Susan” nor “Mark” are stupid. But neither case makes any sense at all. They ignore the obvious truth right in front of them, and do self-destructive things which make no sense whatsoever. And again, they are not stupid.
People are weird.
Lord, help us.
Published in General
A family friend’s daughter got sick in eighth grade. Just miserable: Tired all the time, weepy (well, she was thirteen) sometimes throwing up, headaches. It went on. And on. Her parents took her to the family homeopath, who prescribed a couple molecules of dandelion sitting in a lump of chalk.
Didn’t work. Whatever the next nostrum was, it didn’t work. They took the kid to a shrink. There was plenty to talk about, but her ailments didn’t get better. During the “it’s psychosomatic” phase, she was in a group that I chaperoned on a hike up Mt. Katadhin: It’s a tough climb. She wept and moaned and said her stomach hurt. Her classmates were impatient, her teacher more or less accused her of malingering.
Long story short, at one point I asked my friend “so, have you taken her to a regular doctor?” Was astounded to hear the answer. Nope: Just the homeopath and the shrink. Because: Nature.
‘Take her to the doctor,” I suggested.
“Homeopathic medicines have no side effects,” my friend said earnestly.
“That’s because they have no effects,” I said. Anyway, eventually, she took her daughter to a regular old doctor. Turned out their kid had been suffering from Lyme disease for more than 18 months—which did some real damage. Ai yi yi.
Medical grade leeches aren’t cheap.
Same with the medical grade maggots.
Those parents should not have bred.
I suspect that people who want a miracle cure are more interested in the miracle than the cure.
Have you read Douthat’s The Deep Places?
Doubt it. Pancreatic cancer is relentless no matter how much money you have.
My father was being treated for vascular disease after a few bouts of “mini strokes.” He was placed on some heavy blood thinners as well as iron supplements. After one more “episode,” he was also diagnosed with a severe platelet deficiency and spent a few weeks in the hospital, then rehab, then placed in a nursing home. I raced to FL in the middle of the COVID nonsense (had I flown, I would have had to quarrantine according to his GF) to help him. I visited him at the nursing home, fully gowned, masked, shielded and distanced. He was very unhappy, bruised, drugged and looked like a homeless man ready to call in his earthly chips. I had to get him out of there, something the folks at the facility tried to resist, but I had power of attorney. The following week, his new home physical therapist mentioned Parkinsons, assumed he was afflicted. I later did some research and immediately scheduled a visit to a neurologist. Dad was diagnosed in the hall on his way to the exam. I also questioned the depression, pain, mini-stroke and low platlet diagnoses and took him to a hepatologist. Turns out his platelet counts were fine; they just had a tendency to clump when blood was taken. As for the diagnosis of chronic anemia, he also had a benign genetic disorder called thalasscemia minor, which leads to marginal iron and platelet counts. He was ordered off all antidepressants, opiates, iron supplements and blood thinners and was placed on a single Parkinson’s regimen.
In all, he’d been misdiagnosed by a whole host of specialists, including a cardiologist. They were killing him.
He did very well for a year and a half, my gift to him. In the end, Parkinson’s finally had its way.
There is something in human psychology that once someone is convinced of something it is virtually impossible convince them out of it. I see this all the time with alternative medicines in my family. To be fair, I am not well informed on them. But the passion expressed by them, like they’ve just discovered the fountain of youth, makes it very difficult to persuade otherwise. A few well placed questions often reveal they have no idea what they’re talking about (often neither do it), but it’s like that person that just got sold a timeshare; it’s now the greatest investment ever.
you handled it better than I, doc. this would drive me nuts. it’s one of the reasons I am not a doctor. that and a lack of academic excellence, commitment to detail, and the ability to focus on anything longer than 15 minutes..
Hospital administrators pull in big salaries.
Actually, Steve Jobs had a rare form of pancreatic cancer that is actually successfully treatable according to the biography I read.
That’s a nice way to describe ambulance-chasing lawyers.
That too, but of course I meant the actual maggots sometimes used to debride dead tissue from wounds etc.
; )
I read that Steve had a particularly treatable kind. 2 more years would have been 2 more years
A fine gift, indeed. You pulled him out of misery to a place where he could thrive as long as it was possible. Good for you!
No—I’ll look for it!
I wonder whether a geriatrician —a doctor specializing in problems of the elderly—might have been onto this sooner? I’ve read that (thanks, Medicare!) it’s really hard to find a geriatric specialist. When I was young, and thought I wanted to be a doctor, I worked as a volunteer on a geriatric ward—the old folks had their own ward!—-and because the Medicare effect had not yet kicked in, bona fide geriatricians, surrounded by a gaggle of med students, would make the rounds every day.
I used to read the Bible to the patients, not because I was religious (at the time, I wasn’t: At least, not consciously) but because they asked me to. Since many were hard of hearing, it means that what turned out to be my first sustained foray into scripture was conducted at top volume. E.g. THE EARTH IS THE LORD’S AND THE FULLNESS THEREOF….
One old lady’s name was Annie. She was 104, and had a letter from Willard to prove it. I brushed her dentures for her, and rubbed her very old back with Keri lotion. Then I would yell Isaiah for twenty minutes or so, until she’d fall asleep mumbling “It’s so true. It’s so true.”
The profit margin on many naturopathic and herbal remedies/supplements can be greater than pharmaceuticals and are less regulated- hence why many pharmacies have them available. The products themselves can greatly vary in composition and in the amount of the “active” ingredient available. I have seen patients suffer intracranial bleeding from herbal supplements they were taking as an alternative therapy for prostate cancer.
Exotic lab tests can also have a sizable profit margin and frequently have little documented prognostic value.
All part of the pagan nature worship that is corroding civilization from within.
For a season, we were close to a number of people for whom “colloidal silver” was all the rage. Put it on abrasions, drink it for nausea, drop it into your ear for an ear ache, etc. It was the secret “big Pharma” didn’t want you to know about so they could sell you their more expensive drugs. I looked into it and realized that the amount of silver was miniscule, although there was possibly some anti-bacterial effect on cuts and abrasions. But otherwise, it was completely useless, and if ingested in large enough doses, it could be harmful.
That got me thinking. Big Pharma had factories, easy access to clean water, medicine bottles, filling machines, and, perhaps most importantly, access to markets. If colloidal silver actually worked, Big Pharma would have switched over in a heartbeat and used their infrastructure and access to markets to bottle the stuff themselves. If anyone had a reason to capitalize on an effective “alternative” remedy, it would be Big Pharma. They’d have that stuff flooding the shelves of the local CVS and Walgreens before the homeopathic companies knew what hit them, in large part because it was cheap–mostly water and a touch of “ingredient”.
Regrettably, I think that tells much of the tale about what works and what doesn’t. Not all of it, of course, but much of it.
But there’s not much profit margin in those things, and they can’t be patented.
Fair point, but it’s super cheap. Big pharma hasn’t quit making aspirin or ibuprofen or MOM, etc. just because it’s cheap to make. And that was MiMac’s point—a bottle of colloidal silver sells for $30 for 16 oz and it’s only 10 ppm silver. That’s 0.001% silver (if I did the math correctly). Pretty good pricing for water with some extra minerals. Heck, regular drinking water can have 10 ppm of iron.
And how can you even tell how much “active ingredient” is in a homeopathic remedy? When the stuff is manufactured by diluting…and then diluting…and then diluting…and then diluting…and then diluting….and then diluting….[etc etc] a cup of herb tea and then, when you would be hard pressed to find a single molecule of Nux Vomica or whatever the actual stuff is supposed to be…they put a tiny drop of what is, by now, basically water onto a chalk pill and let it dry.
I had an interview published in a magazine (some sort of wellness thing, can’t remember) that had an article about homeopathy. Straight-faced, the “journalist” quoted a homeopath as explaining that the water molecules magically take the imprint of the herb molecule, and the imprint transfers to the calcium. So it doesn’t matter at all that a chemist can only detect water in the expensive little cobalt-blue bottle or pricey cachet of pellets.
Why don’t water molecules take the magic imprint of all the other things water comes into contact with during the endless water cycle? Seaweed, walrus dung, plankton, grubby swimming children, diesel leaks, crab entrails, bear pee…?
That doesn’t seem like a question that would require an unusually bright or skeptical editor to come up with, frankly. But the editor of this magazine didn’t think of it. Because the homeopathic remedy company advertised in its pages…and also, people are weird.
Some people are capable of getting themselves educated despite going to journalism school, but for most of them, journalism school interferes with education.
It seems to especially interfer with being a good journalist.
And, of course, there is the whole turning blue thing (irreversibly.)
I had a vague recollection of that side effect, but I was too lazy to look it up. Thanks!
Well, yes, because they don’t have enough general knowledge to equip them to ask good questions.