An Apology

OK, I plead guilty to being a week late in this crucial series—one that has the vast readership of SBM sitting on the edge of its collective seat! Proof of that assertion, of course, is found in the overwhelming number of Waluations submitted for the passage offered in the W^5/2 #5: Six. Another apology, if only a minor one: when I wrote, “the ‘plot’ of that paragraph has a little something that’s different from the usual fare,” I was probably wrong. I thought, somehow, that the passage had promoted the idea that “the integrative medicine movement” might offer physicians an antidote to “the limitations managed care has placed on their earning capacity.” Upon rereading the passage, I realized that it had not explicitly made that assertion.

A Wawiety of Cweative Waluations

Your faithful judge was faced with a difficult task this time: there were several clever and thoughtful Waluations, but they were so different from one another, stylistically, that choosing among them became an Apple ‘n’ Orange typa thing. Let’s get to it:

Michelle B‘s economical translation captured the gist of the passage and, for that matter, of most of the agenda of “Integrative Medicine” in a way that is especially pleasing to those of us who, like your humble and faithful judge, learned everything we needed to know about morals and wisdom from TV Westerns in the 1950s. How, pray tell, can we expect our own children to navigate the treacherous shoals of life without such fundamental teachings?

Stu (m’man!), in his usual, all-but-inimitable fashion, revealed the essential ironies of the matter with Stinging Spears of Sardonicism.

joel_grant apologized for not being funny (not that there’s anything wrong with that!), but his translation was accurate and included an important bonus: “That such unhappiness as exists should inadvertently send patients to quacks is collateral damage” is another way of describing the non sequitur that is “integrative medicine,” when proposed as a remedy for the ills of modern medicine.

nicodemus6 also offered an accurate translation, but his was funny. What did he mean, though, by “bad enough that many are no longer calling themselves doctors anymore”? At first I thought he meant that many are leaving medicine, which is possibly true—at least compared to back in the day. Later it occurred to me that he might have been referring to the tendency of many young physicians to introduce themselves to patients by their first names. I think of that as part of a more general cultural phenomenon (I decline to participate in the obvious debate), and I’ve heard arguments that it reflects a discomfort with the authority that society confers upon highly trained professionals or, for that matter, a discomfort with adulthood itself. nicodemus6, we are dying to know what you meant!

Also, good question about medical school enrollment, but probably not the right one, at least not yet: I doubt if enrollment is down, but I’d not be surprised if applications are down. For decades there have been so few places in American medical schools, relative to the number of applicants, that a general diminution in interest would not be reflected in enrollment until it had achieved an advanced state. Somewhere, recently, I read that the most desired residency for American medical school graduates is now dermatology, a field that during my career has been considered a “life-style” specialty: good hours, little or no night or weekend call, plenty of money. The least sought-after specialties, and among the least “life-style,” are those that were the most desired when I finished medical school in 1979: internal medicine, primary care, and general surgery. So yeah, things appear to have changed. But not, as you correctly noted, in a way that justifies quackery, as was also pointed out by the next Waluator.

wertys also cited the non sequitur, this time by its name, that “integrative medicine” represents as a purported solution to “the problems medicine has as a profession.” He offered reasons for the “growth of the sCAM movement” that I, for one, agree with completely. He displayed the same indignation about the issue and about its misrepresentation in the passage that inspired many of us to the cause of “CAM” skepticism—a major theme of Science-Based Medicine. Right on.

Michael X borrowed, to considerable advantage, a page from Stu (m’man!): “The power of simple substitution.” Michael X’s substitution might not have been as timely or as racy as Stu’s, but in its own, humble way it demonstrated the Perpetual Problem of the Patterns of Popular Preferences.

And the Winner is…

wertys, for having Told it Like it Is to an extent that went beyond the call of duty for the Weekly Waluation of the Weasel Words of Woo! Honorable mention goes to Michael X,  for the funniest entry. As for the rest of you, don’t fret: you done good.

This Week’s Entry…

…has gotta be wunna my all-time favorite passages in the Infamous Annals of Asinine Assertions, straight from a book review in the Journal of the American Medical Association:

How does this book change everything? Dossey envisions and graphicallydescribes a medicine of the future. This new era is composedof a blend of the best of what we know of physical, material-basedmedicine (“Era I”), mind-body medicine (“Era II”), and the caring,compassion, and consciousness that characterize “Era III.” Acompelling example is given in the use of all three levels ofcaring in the “Era III Emergency Room.”He vividly shows us a new kind of emergency department in whichan auto crash patient is not only stabilized and sutured buthas the suggestion of relaxation imagery along with the lidocaineand nylon. Meanwhile, caring healers take a moment to pray andvisualize a positive outcome based on the scientific evidenceof the effects of nonlocal mind, employing a network of nonlocalhealers as they work.

Happy Waluating!

The Misleading Language and Weekly Waluation of the Weasel Words of Woo series:

  1. Lies, Damned Lies, and ‘Integrative Medicine’
  2. Integrative Medicine: “Patient-Centered Care” is the new Medical Paternalism

Posted by Kimball Atwood