The divide between complementary healers and scientists seems to be getting wider. There was a time when your patients would happily tell you what the acupuncturist thought. Now they won’t tell you they have a cup of chamomile tea before going to bed in case you come over all scientific and haughty on them. This is a pity. I would hate if any of my patients was afraid to tell me who else they were attending.
Maybe the polarisation of complementary and mainstream medicines is due to the rise of the sceptic and the attack on any kind of mystery.
The danger is that we may be too ready to embrace the cliche.
The complementary therapist thinks of an evil scientist in a white coat in the pay of black-suited men from giant chemical companies. The scientist thinks of a long-haired person wearing a kaftan and waving a wand.
In the real world, qualitative researchers tend to be open-minded and observant people and those at the cutting edge of alternative medicine are as rational and honest as any.
But every few years the arguments start again: it's the left side of the brain versus the right; the masculine versus the feminine; the ying and the yang. The attitude was well documented years ago in "Zen and the Art of Motorcycle Maintenance" as the free spirit versus the scientist. And it is all nonsense. We are all fellow human beings and our aim should be to help people achieve their best, physically and mentally. But the argument is getting increasingly strident and, well, unscientific. It is too easy to forget, for example, that what was a herbal cure years ago can now be a mainstream medicine.
Explaining ECG
I often imagine the task one would have explaining the ECG to a doctor from about 150 years ago .
“Now there is a force in the human body called electricity which, incidentally, causes lightning as well. Yes, lightning.Well, it flows through the body and if I attach wires here and here and, well, in about 12 different places, it writes on this paper – no, there is no scribe – the electricity can do that too, so I get a great idea of what the heart is doing. I can tell its size and rhythm, and whether you have had a heart attack, and a whole lot more. No, I am certainly not being unscientific, Doctor.”
My main rule, when a patient tells me they are going to see a complementary therapist, is to ask the cost.
If they can afford it, and it does not wreak destruction on the mind or the body, I will just ask for a bit of feedback. I am always curious about what is involved.
Some sound like fun. I mean, who wouldn’t want a good chanting session? A colonic irrigation probably has its good points – though I’d rather hear about it than endure it – and a good massage is always nice.
I think most GPs would rather their patients went for an aromatherapy session than demanded sleeping tablets. You can get a bit of acupuncture for morning sickness without letting down the whole fabric of modern scientific thought. And if you feel your patient is being given false hope, the lines of communication are still open.
Lack of evidence
Lack of evidence is not proof that there is no efficacy. I know that wet, used tea bags are a good treatment for mouth ulcers. Now what drug company is going to invest millions in a random-controlled trial to square off its product against a tea bag?
Eating 12 cherries every two days reduces your chance of having an attack of gout. It might sound like nonsense but there is sound scientific evidence for this. The random- control trial, beloved of drug firms, is an expensive, unwieldy beast that often fails to capture the true picture. If something unusual pops up, the evidence is often disregarded.
Many huge discoveries, such as penicillin, were accidents followed by good observation.
There is a lot on a basic level that complementary therapists can teach us, from the way they listen and relate to patients to the way they approach illness, and there may be interventions just waiting to be discovered. The Petri dishes on which penicillin was first seen in action were nearly thrown out.
It makes no sense to ignore the vast amount of work outside mainstream medicine from simple prejudice. If we do, I am afraid we will miss something important.
Dr Pat Harrold is a GP in Co Tipperary.