A Doctor tells it like it is

kw: book reviews, nonfiction, medicine, alternative medicine, hype, advice

As much as I appreciate doctors and nurses, I am rather skeptical of over-confident physicians. However, I am even more skeptical about medical claims, veiled or otherwise, for "alternative" and "non-traditional" remedies and treatments. It is ironic that, in the earlier times when physicians had few useful techniques and fewer genuine remedies, phony doctors seem to have been rather scarce. Since the modern era of "miracle drugs" and effective vaccination, starting around 1800, the "snake oil salesman" became a fixture of Western culture; ironically, genuine Chinese oil of water snake is a pretty good liniment for sore muscles and joints. But the "patent medicines" of the American West…you'd be better off drinking some clean water! . . . and rubbing fish oil or olive oil into sore joints.

Hype, medical and otherwise, got a huge boost with the invention of the World Wide Web, as a service offered over the Internet, after 1993 ushered in the first browser, Mosaic. That is 25 years of rampant self-publishing of everything imaginable. According to an old proverb, the Devil will tell you the truth seven times to prepare you to believe one lie. Many Web pundits don't bother with the seven truths; it is just lie, lie, lie, preying on the gullible. Caveat emptor was never needed more than now!

Hype: A Doctor's Guide to Medical Myths, Exaggerated Claims, and Bad Advice—How to Tell What's Real and What's Not, by Nina Shapiro, M.D. and Kristin Loberg, takes a series of bold swipes at the whole enterprise of online medical quackery, misinformation, and tomfoolery. I had high hopes when I began the book, and those hopes were largely met. Dr. Shapiro knows her stuff, and it is told well.

Do you fear Ebola more than bees? The number of people in the U.S. who die of bee stings ranges from 75 to 85 yearly. Worldwide, it is hard to determine, but it is perhaps twenty times that, maybe 1,500 or so. In the U.S., there have been 11 cases of Ebola, with 2 deaths. Total. Of course, in central Africa, there have been thousands who died of Ebola, 11,000 by one measure. Both bee stings and Ebola pale in the face of the most dangerous thing most of us do every day: ride or drive a car. Safety technology has cut the number of auto-related deaths in half during my lifetime, but in the U.S., the number is still about 40,000 each year, and worldwide, it exceeds 1.2 million. For comparison, the most dangerous insect, the Anopheles mosquito, spreads malaria, which kills nearly half a million yearly (though very few in the U.S.). So worldwide, autos are almost three times as dangerous as malaria!

Another fun subject. Juicing. It is enjoying a resurgence. About 40 years ago, some folks put all kinds of stuff in juicers, and a friend of mine broke his juicer trying to extract the juice from wheat grass. So, you cut up carrots, fruits, and other stuff and extract the juice. What do you get? Tasty (maybe!) water with some vitamins and whatever phytochemicals survive the juicer. What don't you get? Any of the fiber, which is the main benefit of the fruits and vegetables!

Turn your juicer into a museum piece, and just eat an apple, including the skin. If you peel the skin you are throwing away most of the pectin, which is a major ingredient in Kaopectate, a diarrhea medicine. The pectin is behind the proverb, "An apple a day keeps the doctor away". Eat an apple without skin and you are more likely to have a runny B.M. Eat it with the skin, and you probably won't.

More fears: Formaldehyde and Mercury in vaccines. Guess what? If, during your first 18 years you received the usual schedule of 25-30 vaccinations, you received about half the formaldehyde you would consume by eating a single pear! Also, your body makes formaldehyde all the time. In some of those vaccinations, there was also a little bit of mercury in the preservative. How much? About the amount in two tuna sandwiches, if you use Albacore tuna, or four sandwiches made from "light chunk" tuna. There's even less mercury in salmon, so if you want to avoid mercury, eat salmon instead of tuna! And there is even less than that in Tilapia!! My wife and I happen to like fish, so even though we usually go for low-mercury varieties, we probably consume more mercury each year than we received from all our vaccinations (and those we still get, such as the Flu vaccine).

There is advice about detecting hype, though it will be hard for most of us to carry it out. When we are looking for medical information, we are usually worried about something, and thus more prone to believe almost anything that sounds plausible and is presented with an air of authority. At a time that we most need our critical facilities, they are weakest. Every day we read or hear or view ads about medications, some legitimate and some that are really just nostrums. (Def: nostrum. A medicine with unrevealed components, prepared by a private party or non-professional, that is claimed to "cure" ailments that "ordinary" medicines cannot treat.) Some, such as a recent rash of "T-boosters" ("T" is the current euphemism for testosterone), can actually deliver some of the results promised, but they also deliver results that are not mentioned.

To speak of "side effects" is too mild. Boosting testosterone in a man will indeed allow him to grow bigger muscles through exercise, it will indeed make him more "passionate" (that is, lustful), and it will also greatly increase his risk for heart disease and cancer. The ads don't mention that last item or two, do they? Nor do they mention the shorter fuse of any testosterone-addled male at any age. Why are teens so impulsive? Because they have twice the "T" level that they'll have just 10-20 years later. Guess what? The reduction of hormone levels in most men is not only normal, but beneficial, helping them live longer. In fact, one big drawback of too much "T" is the tendency to be accident prone because of increased impulsiveness. And trust me, most women don't want a man who is as randy as a bull elk in rut; things get a lot better when a man learns to slow down.

Here is my take-away as the #1 hype detector: If the beginning of the pitch is selling fear or dread, stop right there. Salesmanship comes in two varieties. One variety is to say, "If you have this need, here is a solution." The other says, "You have a big problem; in fact you could have several big, big problems, but this stuff will make them all go away." And here is my personal rule of thumb: If a company can afford frequent TV ads about their product, its price is much too high. On principle, I keep track of TV-advertised medicines and avoid them. So far, I think I've only had to violate that principle once.

Doctors can come across as stodgy and not so fun. Dr. Shapiro, with the help of her co-author, keeps a smile on your face as you learn a thing or two about keeping your health and your finances intact.