The “Art” of Clinical Decision-Making

Much nonsense has been written about the “art” of medicine. All too often, it amounts to a rationalization for doctors doing what they want to do instead of following the evidence. Medicine is not an art like painting. Neither is it a science like physics. It’s an applied science. Since patients are not all identical, it can be very tricky to decide...

/ May 13, 2008

The early detection of cancer and improved survival: More complicated than most people think

“Early detection of cancer saves lives.” How many times have you heard this statement or something resembling it? It’s a common assumption (indeed, a seemingly common sense assumption) that detecting cancer early is always a good thing. Why wouldn’t it always be a good thing, after all? For many cancers, such as breast cancer and colon cancer, there’s little doubt tha early...

/ May 12, 2008

“CAL”: a Medico-Legal Parable

Preamble From the fall of 2000 to the winter of 2002, the Commonwealth of Massachusetts convened a Special Commission on Complementary and Alternative Medical Practitioners. There were 12 members: 6 legislators, 3 MDs, a naturopath, a lawyer who represented the New England School of Acupuncture, and the chairman, who was also the Director of the Massachusetts Division of Professional Licensure. At the...

/ May 9, 2008

Near Death Experiences and the Medical Literature

MIRACLE MAX: See, there’s a big difference between mostly dead, and all dead. Now, mostly dead: he’s slightly alive. All dead, well, with all dead, there’s usually only one thing that you can do. INIGO: What’s that? MIRACLE MAX: Go through his clothes and look for loose change. — The Princess Bride Can you trust anyone when they purport to tell you...

/ May 8, 2008

Science and Health News Reporting – The Case of the Regenerating Finger

Last week it was widely reported that an Ohio man, Lee Spievak, had regrown the end of his finger that had been chopped off in an accident. Reporters informed us, for example: A man who sliced off the end of his finger in an accident has re-grown the digit thanks to pioneering regenerative medicine. But this was not the real story. The...

/ May 7, 2008

On Being Certain

Neurologist Robert A. Burton, MD has written a gem of a book: On Being Certain: Believing You Are Right Even When You’re Not. His thesis is that “Certainty and similar states of ‘knowing what we know’ arise out of involuntary brain mechanisms that, like love or anger, function independently of reason.” Your certainty that you are right has nothing to do with...

/ May 6, 2008

Mercury emissions from coal-burning power plants and autism: Is there a correlation?

On April 30, outside the courthouse in Dallas, a press conference/rally was held. This particular rally was in response to a new study published by a group led by Dr. Raymond F. Palmer in the Department of Family and Community Medicine at the University of Texas Health Science Center in San Antonio, whose conclusion was that autism prevalence correlates strongly with proximity...

/ May 5, 2008

The Weekly Waluation of the Weasel Words of Woo #5

The Master Speaks It was a delightful surprise for me, and I hope for you fans of the W^5/2, to log onto SBM on Thursday and find this blog by Dr. Wallace Sampson. As I mentioned in that long-ago posting that introduced the topic that eventually hatched the W^5/2, Dr. Sampson is my Yoda, when it comes to the topic that he named: Language Distortions. More about that below....

/ May 4, 2008

The Ethics of “CAM” Trials: Gonzo (Part VI)

Part V of this Blog argued that the NCCAM-sponsored trial of the “Gonzalez regimen” for cancer of the pancreas is unethical by numerous criteria.† To provide an illustration, it quoted a case history of one of the trial’s subjects, who had died in 2002.¹ It had been written by the subject’s friend, mathematician Susan Gurney. A similar story was told on ABC 20/20 in 2000, albeit...

/ May 2, 2008

Integrative Medicine – Sectarians’ Trojan Horse

Integrative Medicine – Sectarians’ Trojan Horse leapfrogs science (Or, I can misuse language with the best of them…) I stumbled across an article from Archives of Internal Medicine, 2002 (Integrative Medicine: Bringing medicine back to its roots. Arch Intern Med. 2002 Feb 25;162(4):395-7). It is one of the first authored by Andrew Weil on “Integrative Medicine “ – another is BMJ in...

/ May 1, 2008