When a pseudoscientific remedy makes a patient feel better

Readers know that I am skeptical over the efficacy of complementary and alternative medicine. This is not merely a demonstration of my inborn skepticism, but doubt based on the fact the so much of their claims are untested, unproven and refuted.

I don’t regard the above comment as controversial. It is factual. I’ll let readers decide if it is but another example of the arrogance of conventional physicians who worship on the altar of evidence based medicine.


I recently read a column in the New York Times by a university professor who was treated for a cold in China by drinking fresh turtle blood laced with grain alcohol. In a day or two, he felt better. Cause and effect?

It’s not easy to talk someone out of a view that a pseudoscientific remedy healed them. Why should we do so? If a patient tells me that his fatigue has finally lifted after giving up guacamole, do I serve him or the profession by pointing out the absence of any scientific basis for his renewed energy level? Or, is the better response for me to celebrate his progress and urge him to continue his “treatment” which clearly poses no health risk?

Guac anyone?

Certainly, if I felt a patient was pursuing an alternative medical treatment, or any remedy, that threatened his health, I would plainly state this so the patient was making an informed choice. If a patient was suffering from a bleeding ulcer, and wanted only herbal medicines, I would make sure that the risks of this choice were well understood.

I need to make a confession here. Physicians face a huge knowledge vacuum with regard to the human body which is the product of millions of years of natural selection. We are no match for comprehending its nuances and elegances. Taking care of patients is a hugely humbling experience. Consider how microscopic germs, organisms that are not sentient and have no brains, can wipe out millions of humans. We should acknowledge that we’re not that smart.

There’s another possibility to be considered when a patient relates the success of remedy that we don’t support or understand. It might actually be working.

Have you been tired lately? Fatigued? How much guac have you had lately?

Michael Kirsch is a gastroenterologist who blogs at MD Whistleblower

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  • Lisa

    The placebo effect is real; don’t discount it.

  • Observer

    I sighed when I read this:

    “This is not merely a demonstration of my inborn skepticism, but doubt based on the fact the so much of their claims are untested, unproven and refuted.

    I don’t regard the above comment as controversial. It is factual. I’ll let readers decide if it is but another example of the arrogance of conventional physicians who worship on the altar of evidence based medicine.”

    then laughed out loud when I read this:

    “There’s another possibility to be considered when a patient relates the success of remedy that we don’t support or understand. It might actually be working.”

    Nice to find a doctor who understands how much of ‘our own brand’ of medicine is not yet scientifically grounded.

  • John C. Key MD

    Many patients get “in” to alternative or complementary medicine not because they are wierdos, but because they are driven there by the failures and problems of orthodox allopathic medicine…as well as by the “arrogance of conventional physicians”.

    I know whereof I speak, for I was one of those conventional physicians, and probably arrogant at that. I got over it when my wife was stricken with rheumatoid arthritis, and despite taking literally thousands of dollars worth of state-of-the-art medication, was doing very poorly. Her rheumatologist–a very bright young fellow– was quite satisfied since as far as he was concerned as long as the sed rate and CRP were improved, then she was doing great. Pain, disabilitly? So what–the lab looked good.

    We sought another opinion from another qualified rheumatologist. About the first thing she said was, “you need to have a green smoothie every morning” and pursue an alkaline anti-inflammatory diet, drink alkaline water…we did, with amazingly good results. Oh yes we still use the biological agent and methotrexate, but for the first time in six years the pain is manageable.

    In 40 years as a practicing physician I’ve learned several things: (1)we doctors aren’t as smart as we think we are (2) arrogance and condescension help neither patient nor physician (3) complementary techniques can be a very good thing, and (4) the treatment recommendation for peptic ulcer disease changes every 20 years.

    • NewMexicoRam

      I’m with you.
      I’ve read the book Wheat Belly recently, and I’ve eliminated wheat from my diet because of the inflammatory and acidic properties of starches. I’ll be checking a lipid and inflammatory panel soon, to see the results.

  • Patient Kit

    Evidence-based medicine is great, to a point. But it has it’s limitations. It can only measure things that are measurable. It’s not so great at measuring things like pain, quality of life, values, priorities and the mind/body connection of whole people. If it is cold hard numbers that are worshipped, what’s good for most isn’t necessarily good for a particular individual. We don’t “know” everything. Plenty of mystery, complexity and chaos remains. Everything isn’t always logical, provable or explainable. Science isn’t all there is. Many believe there are forces more powerful than science in the universe and science can’t prove that wrong. I think there is plenty of room for alternative/complimentary medicine to co-exist with EBM. That said, it’s unlikely that I’d ever consider giving up guacamole (or margaritas). In moderation, of course.

    • Lisa

      Hey, some people would consider margaritas to be complementary medicine.

      • Patient Kit

        I know I do. Good tequila is good for stress reduction. Is agave a vegetable? Fresh lime juice has vitamin C (from the source, not a supplement), margaritas come with the company of good friends and family. If you have a sore throat, have a frozen rita instead of on rocks to soothe your throat but be careful not to get frozen headache. :-p

        • Lisa

          My favorite cure for a cold is sushi with lots of wasabi. The wasabi helps with the congestion and if you drink enough sake you don’t care if you have a cold.

          • Patient Kit

            Sushi is one of my favorite meals and you’re right about the wasabi being good for cold symptoms. I like a lot of wasabi with my sushi. Not a big fan of sake though. With margaritas, I like lots of chipotle and habenero with my food. Spicy food beats cold meds for relief from most cold symptoms (except for bad cough). Plus, you really shouldn’t take cold meds with tequila. Chipotle, however, goes great with tequila. Yep, there’s a place for alternative/complimentay medicine. :-D

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