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Homeopathy Thought for the Day

17 January, 2013 Reply

Homeopathy is based on the crackpot ideas that: (1) “like cures like” – sympathetic magic that was abandoned long ago in favour of, well, reality; and (2) the more you dilute (and shake, or “succuss”) a solution of a substance, the more potent that solution becomes – even to the point that Avogadro’s Number is exceeded, and it’s not a solution anymore … it’s just water.

Yes. Honestly. That is indeed what they believe. And many many people fall for it. Many people apparently don’t really know that’s what homeopathy is; they think it’s herbal medicine or something. Now herbal medicine can be fine; take aspirin for example: bark of a willow tree. Once you test it and ensure that it works, and can produce the active substance without contaminants in consistent amounts/doses, you have a safe and useful medicine. Even if you don’t do that (and you just eat the bark or whatever), the herb/substance might well have some effect. But homeopathy is just water. Just. Water. If simple logic and rationality don’t tell you a drop of water placed on a sugar pill (from which it clearly evaporates … more on this) will not do anything, then go look at some science.

Now, that’s background. What’s the thought I had? It relates to that drop of water evaporating, actually. It also has to do with the fact that all water on earth has had something in it, and has been shaken and diluted – over many millions of years. Ok, a lot of that “something” will have been dinosaur poo, and I don’t know what that’s supposed to cure, but still ….

Now, the air we breathe is not just nitrogen and carbon dioxide and oxygen and such, there’s a bit of water vapour in there as well (you can see where I’m going with this). Clearly that water is even more diluted (for a start, it’s only 0.247% of the atmosphere, according to Wikipedia). It’s not just even the dinopoo water either; it’s all the drops that have evaporated from all the homeopathic remedies. Thus they have all been even more diluted, and the wind will of course keep them in a constant state of succussion.

So, as far as I can see, the air we breathe is the most potent homeopathic remedy there could ever be.

And that’s actually really true ….

Oprah, Quetiapine, and I’m Knackered

9 December, 2013 Reply

I is buggered.

Normally, this absent time and mental energy I would fill the empty bloggal spaces with lolshrink. However, I no can has even the capacity to translate this into lolspeak. What with my registrar (resident in US-speak) being away for two weeks for exams then having to be off a good half of the time he’s been back: sick himself or looking after his sick child, and work being stupidly busy, I’m knackered. I don’t begrudge him the time off btw, I’m not that entitled and uncaring: he has to look after his family and himself first. No problem with that – but I am knackered. Especially given that Miss5 decided to wake us up between 2 and 3 am for the last 3 nights running; I was up for an hour this morning >_<

What has two thumbs and didn't get time to attend the work Christmas party lunch yesterday? ....

I would normally go to Orac’s blog and get the direct link to his post exhorting us all to contact Oprah damn Winfrey to remind her of a particular cancer sufferer who eschewed real treatment in favour of The Secret, and promoted woo-fully by Winfrey, and has stage IV disease and will die – probably sooner/more unpleasantly than if she had actually sought treatment. We should flood Oprah’s contact boxes, but I’ll have to ask you to find the post yourselves on Respectful Insolence (linked above).

I might normally witter on about the way quetiapine is misused in patients where it’s not indicated (it’s indicated, though not necessarily funded, in Australia for generalised anxiety disorder, major depressive disorder, bipolar disorder, and schizophrenia – so pretty wide anyway). In these cases it’s simply the sedative and tranquillising effects being sought – which places us, once gain, squarely in the role of controlling undesirable behaviour. Not treating psychiatric illness.

Seriously, my profession really needs to grow a brain.

But I’m knackered, so I’m not going to blither about that.

I’m going to sit here on the train and ignore the world. [reaches for iPod]

Bye-bye

The Medical-Industrial Complex & the Shadowy Cabal of Doom

21 October, 2013 2 comments

It’s time: time for someone to stand up and come clean about what the proponents of “complementary and alternative medicine”, and the antivaxxers, and their comrades-in-arms have been saying: we are evil. There, I said it.

Proponents of CAM, and opponents of vaccines and allopathic medicine have for a long time been saying that Big Pharma is in cahoots with the Medical-Industrial Complex and has politicians in our pockets. This is of course, they say, why we vaccinate: to destroy children’s immune systems and even infect them with various diseases. We cause cancer by various nefarious means, and withold numerous guaranteed cures, so as to maintain control over the masses.

Of course we deny this vehemently. We are here to serve, we have people’s best interests at heart, we’re actually normal human beings rather than demons made flesh, and so on ….

But I can’t do it any longer. I have to come clean. You need to accept that there is a shadowy cabal of evil (sorry: The Cabal Of Doom) to which doctors, pharmaceutical companies, politicians and so on all belong, that is bent on maintaining control of the masses by way of making – and keeping – you ill. By keeping you ill we make oceans of money, lord it over you, and get to laugh like Vincent Price (he’s actually not dead; we know how to live forever – another thing we keep from the unwashed masses – and we have him in our underground lair teaching new inductees how to do a really good evil laugh).

The thing is, I’m tired. Being evil takes a lot of work. The secret handshakes alone take up half my day. And coming up with new ways to hide the bodies … that is really getting hard. But the worst thing?

The Cabal Of Doom has a damn good recruitment pitch, but their accounts department is total crap. I haven’t yet been paid for my evil works from back in 2006! Seriously, where’s my (3rd) yacht? My hookers and blow? If I don’t start seeing some of this I’m going to consider seriously just not being evil.

In all seriousness, I might actually have to leave the Cabal Of Doom if they don’t start paying me properly. You think the Government is tight? Try getting money out of a shadowy cabal (of Doom) sometime. Honestly, if I weren’t the Antichrist I think I’d just give it up and start trying to help sick people.

Magic, ghosts, and woo

29 July, 2013 6 comments

Magic. Ghosts. Spirits. These are things that pop up in fairy tales and in children’s stories and tv shows & films. Sometimes even they’re debunked – for example in Scooby Doo (though I personally have never liked it) it’s always some guy with a mask and a clever contraption and some flashy chemistry – never a ghost. Never magic. Never paranormal.

Generally though, we accept these magical things in kids’ stories. Well, not if we’re Richard Dawkins we don’t, but I digress ;) We accept them in fantasy fiction as well, even as adults, because we’re clear about fiction vs non-fiction; we know when we’re reading a fairytale and when it’s reality.

Don’t we?

Apparently not, given the widespread belief – among adults – in magic and ghosts. You know: those things that even Scooby Doo debunks.

I was in our lunchroom at work yesterday (somewhat unusual, but then again it was 2:30 or so, so I figure it was reasonable for me to have some lunch :P ) and a couple of members of another team were in there. I didn’t stay long, but long enough to hear one of them telling the other – quite seriously – about someone she knew (not a patient) who supposedly sees spirits or similar. Read more [+]

Homeopathy equal to antidepressants?

25 June, 2013 2 comments

I just saw this, tweeted by Annabel Bentley in London. David Tredinnick, a conservative politician in the UK made an “Early Day Motion” (appropriate, really):

That this House welcomes the double-blind study conducted at the outpatient clinic at Jundiai Medical School in São Paulo, Brazil, which consisted of patients with moderate to severe depression; notes that patients were randomly assigned to a double-blind treatment with individualised homeopathic Q-potencies or fluoxetine (Prozac); further notes that the non-inferiority analysis indicated that the homeopathic Q-potencies were not inferior as compared to fluoxetine in treatment of this sample; observes that the study is the first randomised controlled double-blind trial with a reasonable number of subjects to draw conclusions about the homeopathic treatment of depression; acknowledges that homeopathy is recognised as a medical specialty in Brazil; and calls on the Government to carry out further research into this area.

I guess he’s completely ignored … well, the fact that if homeopathy has any specific effect we might as well burn pretty much every textbook on Earth, but also the recent meta-analyses suggesting that antidepressants are not more effective than placebo for less than severe depression. While I do take issue with those studies, as I mention towards the end of this post – just above the lolcat ;) and agree with the very nice analysis of Richard Friedman MD in the New York Times, I do think there is a kernel of truth. I wonder if severity here is a marker for biological illness (such as melancholia) as opposed to a reaction to the “slings and arrows of outrageous fortune”. In other words, I suspect that groups made up of milder depressions contain more people who – despite meeting the operational criteria in DSM or ICD – do not have a biological illness. If that is so, it is perhaps not surprising they don’t respond well to biological treatments such as medication. The corollary of that would be that groups of more severe depression might contain a higher proportion of biological illness, and therefore respond better to biological treatments (similar to the way that ECT works better the more severe the depression).

In clinical samples, 2/3 of depressed patients have a Hamilton Depression Rating Scale score indicative of severe disorder. This study (full text free, so go check it out yourself if you want) they used the Montgomery Asberg Depression Rating Scale. Scores of 35 and above on the MADRS are generally taken to indicate severe depression. The mean baseline MADRS scores in this study were 27 for the homeopathy group, and 28 in the fluoxetine group. Moderate depression – which I think 3 recent meta-analyses have said fluoxetine is no better than placebo at treating. After 4 weeks the mean MADRS scores had dropped to 9 and 12 respectively, with no statistically significant difference between the two groups.

Sadly (though unsurprisingly), there was no placebo arm. This is my main problem with the “non-inferiority” trials I’m seeing lately. The results for the study treatment are predicated on some other treatment working – and working well. In this case we can’t say that fluoxetine definitely works (compared to placebo) for moderate depression, so where does that leave the results of this trial?

I’m not amused either. If they want to prove that homeopathy works, do a properly-controlled randomised placebo-controlled trial – just don’t waste any public money on it, because:

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