Еще о гомеопатии

[traveller2]

Я никого не собираюсь ни в чем убеждать. Ни в коей мере не оспариваю ваше право ходить или не ходить к гомеопату. Вопросы веры вообще не подлежат рациональному обсуждению. Каждый человек может распоряжаться своей жизнью так, как ему/ей хочется

Comments

[gingema]

Можно сколько угодно обЪяснять человеку, что статистически он не должен поправиться, но если он при этом поправился, ему плевать на статистику. Я не собираюсь лишать себя и своих близких возможности исцеления только потому, что эта возможность "ненаучна". Задача медицины - лечить людей, а не вписываться в статистику.

О медицинских экспериментах и evidence based medicine только на прошлой неделе читала очень печальную статью. Медицина - не физика, в ней не бывает чистого эксперимента и чистого результата. И что еще гораздо хуже - в медицинских экспериментах всегда есть заинтересованная сторона.

Гомеопатия не заменит операцию или антибиотики, когда они необходимы. Она на это и не претендует. Зато конвенциональная медицина со всеми ее научными претензиями так и не умеет лечить проблемы концентрации, многие кожные болезни, мигрени, аллергии и автоимунные расстройства. Просто надо не только что-то принимать на веру, а что-то выжигать каленым железом, но и отличать одно от другого.

Желаю здоровья и долгих лет Вашей родственнице.

[yyi]

clearly, in this case homeopathy does end up trying to replace an operation.

imho, it might even work - just as a placebo might even work. human body is an amazing mechanism, and the placebo effect is quite enormous, often competing with some of the most advanced medicines, whose biological mechanisms are well understood and hardly disputable.
from this point of view, in my humble (and non-medical!) opinion, perhaps I could side with you on the issue of homeopathy, but from the point of view of the importance of preserving the placebo effect, even if scientifically we know for fact that there is nothing of substance there. but the danger is that the placebo measures in many cases end up "competing" with "real medicine" (as in the case cited in the post), and then the results can be very dangerous.

[gingema]

> clearly, in this case homeopathy does end up trying to replace an operation.

Откуда это clearly? Миша рассказал своими словами о решении его родственницы в Москве, так, как он его видит и понял. Мнения и решения ее гомеопата никак в посте не указаны. Равно как и подробности-обстоятельства. Может, врачи настаивают на операции, считая, что с операцией шансы 10%, а без операции - ноль.

[yyi]

I do not know the details of this case. it is possible that the difference is not as significant.
but it is possible also that the case is more like I described. no point in guessing - my comment clearly applied to the later case, and my impression (possibly wrong) was that the case Misha was talking about is of that kind too.

[green_eegs]

а "реальная медицина" видимо кажется всегда правильной, так?

ой боже.

[yyi]

of course not. I am not that naive. but there are cases when at least with high probability "real medicine" does have a decent understanding and decent medical options, which are with high probability going to be more effective than placebo.

[green_eegs]

eh. read what the neurosurgeons said. perhaps the obnoxiousness will not be as obvious to you as it is to me. their attitudes makes it very difficult to recommend surgery.

[yyi]

i scanned some comments in this post - yours, shkrobi's, and a few others, and realized that life is surprisingly more complex, even when things look fairly straight forward. so, yes, I no longer delude myself that know anything. it still smells a bit more like black magic then the "normal medicine", though

[green_eegs]

not sure. when i was "growing up", EBM was a mantra, a prayer, a magic fix, like TRANSLATIONAL is now.
with time it became clear that EBM is flawed, and that there is no real science in medicine, just experience, use of modern technology, and skills based on mentoring of the most elemental, "artisan" kind.

this pill is hard to swallow for those that invested their entire career in "medical science". they hate you when you point it out to them that yes, there are some valuable scientific endeavors around medicine, and important discoveries may be made (once to twice per century, usually) as before, but that the daily practice of any medicine is - skill, artisanship and "black magic".

sorry to disappoint you. however you don't look like someone who BELIEVES in MEDICINE, and you can take it like a man ;-)

[yyi]

of course I do not "believe" in medicine. but it seemed to me that there are tons of "standard" cases where problems are reasonably well understood and reasonably effective treatments are well-known (even if the exactly mechanism of how they work is not clear, as the couple interesting posts from shkrobi illustrate). perhaps what you are describing are the more challenging cases? perhaps that you as a specialized and highly qualified expert get to see, but most doctors treat much simpler and much less black magic? I mean after all I do try to find a good doctor, but over all there is a strong sense that most doctors will do just fine. if it were black magic, then would not the choice of a doctor have major effects in most cases, not only few extreme cases?

[green_eegs]

I am just saying - be sceptical of any medicine, do not think of it as science

[yyi]

I get what you are saying - and to an extent, I think, it applies to any science, not just medicine. which is kind of my point. :)

this is a very interesting discussion. in my own case, I used to pick doctors "by convenience", until ~50years - at that point I switched to a doctor, whose office is less convenient, but whom I knew for many years, kind of as a friend, and good friend of other friends (incl., Dima K.), and about whom I heard lots of good things (incl., from Dima). I did that exactly because I figured that probability of non-trivial cases, where the doctor's choice would matter, after 50 is no loger "negligible", and just in general, I wanted someone I could trust reasonably comfortably. so, there I guess, I am following more of a "black magic" paradigm myself.

[green_eegs]

I hope D. is doing okay... have not heard much lately. which is good, i hope.

there is no rational way to choose a doctor - and yours is as good as any.
i remember arbat tried to come up with an algorithm, and it was ludicrous.

the truth is - no one can really know how good a doctor is. i mean. NO ONE. and nobody realizes it as well as we, doctors. rarely we work with colleagues outside of my specialty close enough to judge...... how did i choose a cardiologist for my dad? he needed a pacer. where i was at the time, i had known everybody in cards.. intimately. and yet i did not know how to choose. one woman was secretly known as a 007 - however how do i know if it is her technique or patient selection? i would not know, i cannot judge her skills. however i made sure it was not she. just in case.

now my parents moved here. my dad needs a cardiologist... what do i do? i pick up a senior professor. is he good? how do i know? i don't.....

[yyi]

right. I try to make sure that in addition to hearing something good about the technical qualifications, I also get someone who would hopefully use a bit more attention and care, just because I am a bit more than any patient to him...

[green_eegs]

well... i had met some of the worst, shameful medical "pirates" who were deeply beloved by their swindled patients. i guess handholding alone can be a placebo.

[yyi]

it sure can. and I realize that too. I just hope that some of the stories I hear minimize the chances of getting a pirate. bottom line - getting a pirate for a doctor has probably nearly uniform probability. the real choice is get a total stranger or get a doctor with a personal connection. of course, some pirates (kind of like Madoff) function by using connection channels to increase their chances of being selected. but imho, doctor selection pre-disposes most people to select with that type of bias anyway.