Dr Jim Duthie
Despite not knowing much about biology, and being able to successfully treat very few diseases, doctors in the 19th century were held in very high regard. For the most part, they would poke, prod, listen to a chest, and prescribe morphine, and yet, they were considered oracles of healing and were never questioned by their patients. Something about medical practice in previous eras inspired enormous confidence, even though life expectancy in Western Europe, the home of modern medicine, was only about 47 years for men before the 20th century. So now with a life expectancy of 80 years or more in most Western countries and climbing, even with an increasing burden of obesity-related diseases, you would think people would be ecstatic about modern medicine. They would surely have abandoned all remnants of primitive ‘folk medicine’, and placed all their trust in the power of the scientific method as applied by health professionals, surely?
I am not claiming for a moment that the increase in life expectancy is due only to advances in clinical medicine. Clearly factors such as food security, improved housing, and sanitation have played an enormous role; although even these advances, in many cases, have their roots in sound medical research. Without Dr Ignaz Semmelweis, for example, we would not know that we should wash our hands, and without Dr Edward Jenner, small pox might still be the leading cause of death in Europe. But paradoxically, the better medicine gets, the more people turn towards alternative health practices.
Various explanations for this phenomenon have been suggested, and perhaps several have contributed. Some say it is the failure of medicine to have cured cancer. If this is the perception, it is an incorrect one. Cancer is obviously not one disease, but a description of cellular behaviour that is applied to a very heterogeneous collection of disorders, and in fact, most are now curable.
It may be the fact that doctors are not allowed to make unsubstantiated claims, or flat-out lie. Alternative practitioners can effectively ‘promise the moon’ with impunity, while dishonest doctors can face charges; we cannot simply tell people what they want to hear. There is also a misperception, particularly exploited by manufacturers of health supplements, that the word ‘natural’ is synonymous with both ‘safe’ and ‘effective’.
Is alternative medicine more effective than modern medicine? Probably not, given that, for example, infant mortality was 12% in the Middle Ages when ‘alternative therapies’ were the only option. Furthermore, if an alternative therapy is proven to work, it ceases to be alternative and becomes evidence-based medicine.
Have people simply become so accustomed to good health that they are unaware of how far medicine has taken us? It may be that a devolution in hierarchical structures in society, democratisation of knowledge, and platforms such as the internet have created the misconception that not only is everyone entitled to an opinion, but that all opinions are of equal value. As a result, a statement such as ‘lighting a candle in your ear will suck harmful toxins out of your body’1 may be considered by some as comparable to ‘surgery combined with platinum-based chemotherapy has been proven to achieve a 98% cure rate for advanced testicular cancer, a disease that was previously uniformly fatal’. The testimony of a neighbour, an unidentified friend-of-a-friend, and particularly a celebrity, wields disproportionate authority with some people.
My opinion is that the fault lies with the ‘industrialisation’ of medicine. With the introduction of publically-provided healthcare in the West, a massive amount of social good was achieved. Families were not made uniformly destitute when the breadwinner became too sick to work or pay for a doctor. There were options other than begging for the disabled poor. No-one had to die in pain because they could not afford drugs. Unfortunately, the culture of medicine had to adapt. Instead of visiting private patients in their own home, taking as much time as needed to listen to their woes, holding their hands, personally administering drugs, and smoothing the pillow, doctors faced unprecedented hordes of very sick patients. Allocated limited resources, hospitals focused on the greatest benefit for the greatest number, and became ‘health factories’, treating and turning over patients as efficiently as possible. With market pressures, even private hospitals have adopted this approach, albeit with nicer linen on the beds and a glass of wine with dinner. There is now little time for ‘caring’.
We usually see a doctor in order to feel better; to be reassured that our cholesterol is not too high; to make a headache go away; to be sure the pain in our chest is nothing sinister. Sometimes, doctors do not make us feel better. They may prescribe blood pressure medication that gives unpleasant side-effects, when the high blood pressure itself did not cause any symptoms; they might tell you that your disease is terminal; they might not give us the hour of conversation we need to work up the courage to share that we do not really have a headache; we just need to tell someone about a horrible thing that has happened to us.
In an alternative health session, despite the candles/herbs/invisible energy beams likely being no more effective than a placebo, a person is listened to and taken seriously. It can be like seeing a psychotherapist without the stigma; like talking to a neighbour back in the days of strong community. When listened to, we feel validated, and importantly; better. It is difficult to stomach disingenuous or even dishonest claims by largely lay practitioners purporting to be experts, and there are many horror stories of significant diseases being left to advance while ‘treatment’ was undertaken, but we must acknowledge that the alternative health industry does provide something for people in need. It just probably is not what they advertise.
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[1] Ear candling is an actual alternative therapy falsely attributed to the Hopi Native American tribe, which can cause burns and ear blockages, and, unsurprisingly, has not been shown to be of any benefit.
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