February 23, 2009

Bad Medicine

By Dave

Late last night my eldest daughter came downstairs complaining of a great deal of pain from an earache that just would not let her sleep. I could tell right away that this wasn’t a trivial complaint, plus she’d been congested for a week, so it was reasonable to assume that some of the congestion had moved into her ear and possibly become infected.

Concerned about what I could do to lessen her pain so that she could sleep and hopefully get up in the morning feeling better, I called our HMO’s health center to talk to a 24 hour nurse about the best way to treat the problem. Now, this is a nice service that the HMO offers. It’s a lot better to have a nurse to call than to get panicked and go to the emergency room or just tough it out until the next day and go in and see a doctor. A lot of problems can be solved with a little good advice over the phone and it keeps costs down for everyone. Basically a great feature for an HMO to have.

That is, of course, assuming the information the nurse gives you is useful, correct and medically valid. So I get hold of the nurse and run down my daughter’s symptoms and get some advice, including giving her decongestants (I already had) and ibubprofen (I already had) and a recommendation of a position for her to sleep in – different from the one I thought would be good, so definitely some help. Then out came the suggestion that gave us some hope for a modern, medical way to deal with the problem – over the counter anaesthetic eardrops. Yay! Something I could go to the store and pick up and give my daughter and say “here’s some medicine, you’ll feel better soon.”

As a parent I know perfectly well that there’s not an awful lot that can be done for an earache in a 12 year old. It’s going to hurt, then it’s going to get better and that’s the way of it. The doctor will want to throw antibiotics at it, but they won’t do anything for it until well after it clears up on its own, but something to lessen the pain until it clears up, now that’s appealing, especially because you don’t really want to tell the suffering kid to “suck it up” and live with the pain until it eventually goes away. So all excited, I hopped in the car for the 20 minute drive to the nearest 24 hour drugstore to get some Similsan.

I guess maybe the name should have tipped me off – ‘simil’ implying similarity to medicine rather than actual medicine. And that’s what I discovered at the drug store. Similsan isn’t over the counter anaesthetic ear drops – something that does exist if you have a prescription – it’s homeopathic, meaning that it has virtually no actual medicine in it, it’s just water which someone basically waved some medicine at and the water is supposed to ‘remember’ the medicinal qualities. To make Similsan eardrops even more exciting, the ‘ingredients’ aren’t even anaesthetic or curative of anything even if they were present in measurable quantities. Chamomile and Sulfur have no known topical anaesthetic qualities. So it was another 20 minutes drive back home to tell my daughter that the ‘medicine’ the ‘nurse’ recommended was statistically no more effective than warm tap water for her affliction. In fact, I could make a better anaesthetic eardrop with things I have sitting around the house like aspirin or menthol or the bull nettles growing in the back yard, all which do actually have some topical efficacy.

Of course, by the time I got home the decongestant and pain killers had kicked in – actual medicine that works – so it wasn’t as pressing an issue as it had been. I’d just wasted about an hour of my day on the recommendation of some lady who claimed to be a nurse who I had thought would be trustworthy because she worked for our doctor’s clinic. What actually bothers me here is that a medical professional should be recommending a homeopathic remedy and that a reputable nationwide pharmacy chain should be selling the useless garbage. I realize that there are a huge number of gullible people who believe that homeopathy works, but as a medical treatment it repeatedly fails the test of both scientific analysis and plain common sense.

There’s a great article on homeopathy in the Free NewMexican. The teacher in this article has a book out on the subject which is available from Amazon. John Stossel did an outstanding expose about it on 20/20 in 2002. I’d give the link, but you have to pay a ridiculous amount for a transcript. There’s also a really good, comprehensive history and explanation of homeopathy on the Skeptic’s Dictionary website. Extensive studies have been done on all sorts of homeopathic remedies, and the results invariably show that their effectiveness is within a statistical margin of variation of placebos. Homeopathy is a classic example of magical thinking, where a scientifically valid idea – the basic concept of vaccines – has been extended beyond the point where it actually works. It sounds good to the gullible, but doesn’t stand up to any scientific or logical test. I’d just as soon put my faith in a gris gris, a magical amulet or a prayer wheel, and they’d be just as effective.

The scary thing is that homeopathy is a $200 million business and an awful lot of gullible people believe in it. The pharmacy I went to actually wanted $9.95 for what was in effect 4 ounces of pure water. The good news is that since there’s not actually anything in the homeopathic medicines they at least aren’t dangerous, unlike many of the unregulated herbal remedies on the market. Nonetheless, I’d really rather not have supposedly trained representatives of our medical system encouraging the use of magically contaminated water when I go to them for help. It tends to degrade my confidence in healthcare professionals as a group and make me wonder what we’re paying all this insurance money for. I half expect my next visit to the doctor to include diagnostic chicken feet, phrenology and the extraction of elfshot.

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