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Dr. Lowe How to Prepare Patient-to-Patient Fibromyalgia Research Foundation
The Metabolic Treatment |
On May 13, 1998 (during the pre-Congress Internet communications of participants), John Diamond, M.D. made several comments I wholeheartedly agree with. I concur with him (at the risk of misrepresenting what he wrote) on several points: Modern medicine was destined to fail in its presumed attempt to provide the public with health and well-being when it: (1) subscribed to the Cartesian division between mind and body; (2) assumed symptoms to be "errors by the body," the removal of which constitutes a "cure"; and (3) ignores biological individuality. In concluding, he made another statement I agree with: "One of the great pitfalls of emerging paradigms is to use the old paradigm's benchmarks to justify, prove, or define itself." Implying that the scientific method was a benchmark of the paradigm that is presently crumbling, his next statement was ". . . the scientific method may be inappropriate." This statement raises in my mind the issue of what I view as a fundamental fault in the old paradigm. It is a fault that, if not corrected, threatens to compromise the value of the new paradigm. The fault is a failure to use the scientific method, by which I mean the rigorous use of correct reasoning in the formation of our scientific beliefs. I believe the three conceptual faults of the old paradigm that Dr. John Diamond mentioned are a product of this underlying problem. (Incidentally, many people seem struck with disbelief when I remark that the scientific method has been sparsely and poorly applied in medical science. Nonetheless, some argue (see the two references below[1][2]) that despite the massive amount of published research, the effectiveness of only about 15% of medical interventions has been validated by formal scientific methodology.) My old friend, Robert S. Mendelsohn, M.D. (who, if still alive, would have enthusiastically taken part in this Congress), made this point back in the 1980s in several books (Confessions of a Medical Heretic, MalePractice: How Doctors Manipulate Women, and How to Raise a Health Child in Spite of Your Doctor). Bob argued that what the popular press calls medical science is more accurately described as the Church of Modern Medicine. In his analogy, physicians are the priests, and their aim is to persuade the congregation of patients to submit to the authoritarian dogma of the Church. His point was well taken: He catalyzed a movement of patients and heretical physicians who defiantly challenged the dogma. This movement contributed to the current widespread determined opposition to orthodox medical authority. Despite this opposition, I suspect that most people will continue to acquiesce to authoritarian medical dogma. They find it easier to accept without question the axioms, postulates, and other assumptions issued by others, and then let the chips fall as they may. This tendency is not all bad, of course. The volume of new information that flows forth necessitates that we often trust the judgments of those we consider authorities. But problems can develop when we take careless advantage of this convenience. Thus, for illustration, it appears that incalculable numbers of people have died of heart disease that could have been averted, had they taken enough supplemental B vitamins and lowered their homocysteine levels. But they failed to do so. Why? Their well-meaning but misguided physicians assured them that medical science had proven that we get enough vitamins in our foods and that vitamin supplements are of no value. As another illustration, a medical researcher may ignore important clues to the solution to medical problems, delaying the solution for decades. The reason? Because he compliantly accepts as scientifically established a dogmatic belief of authorities in a field that overlaps his own--a belief falsely professing that a particular class of clues is irrelevant to the problem he is studying. Let me give a brief example of this. Richard Garrison, M.D., others, and I are actively studying the use of thyroid hormone as a treatment for fibromyalgia. More times than I can count, my particular efforts with this experimental treatment have been seriously hampered by authoritarian dogma accepted as scientific fact. The problem is the current clinical paradigm of endocrinology. This paradigm is expressed in a false proposition: that the serum basal TSH level is the "gold standard" for diagnosing thyroid hormone deficiency and for adjusting the patient's dosage of thyroid hormone. In line with this, those who believe this proposition make two pronouncements: (1) If the TSH level is within the normal range, then the patient cannot possibly have too little thyroid hormone regulation of cell function, and (2) taking enough thyroid hormone to suppress the TSH level is hazardous and possibly life-threatening. Based on these false beliefs, many physicians have actively opposed my use of our treatment that ignores these mandates yet gets patients well. Acceptance of authoritative dogma is synonymous with a rejection of the first rule of reason of traditional rationalism. This rule says to examine the relevant evidence before accepting and acting on a belief. It is this that I believe is the more fundamental fault underlying those that Dr. John Diamond listed. It is also the reason philosophers of science generally consider medical science primitive and unsophisticated. I believe a novel solution would be a commitment by medical clinicians and researchers to a purely rational path to our beliefs. I believe we should: (1) question all preconceived ideas; (2) refuse to unquestioningly accept anyone's belief, except for temporary expedience, simply because he or she is considered an authority; (3) willingly, albeit cautiously, abandon beliefs that conflict with the available evidence; and (4) tentatively adopt rather than dogmatically adhere to beliefs that are best supported. It seems to me that this approach is one we must adopt, if the emerging new paradigm for the healing arts stands a chance of serving us better than the old one. References
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