Richard Niemtzow

"Dr. Seuss monsters": The quackery that is "battlefield acupuncture" continues to metastasize

oracknows — Wed, 29 Mar 2017 01:00:58 +0000

"Dr. Seuss monsters": The quackery that is "battlefield acupuncture" continues to metastasize

After yesterday's post on a local news station's credulous promotion of quack acupuncture (but I repeat myself) for pets, I thought I'd stay on the topic of acupuncture for one more day. The reason is that a reader sent me a link to an article in Stars and Stripes that really irritated me, Acupuncture becomes popular as battlefield pain treatment. Longtime readers might remember that I've been writing about the utter ridiculousness and lack of science behind "battlefield acupuncture" and how it makes no sense to be sticking recently wounded soldiers with needles under battlefield conditions. Out of curiosity, before I proceeded to discuss this article and what's going on with battlefield acupuncture in 2017, I decided to try to find my first ever post on battlefield acupuncture. It depressed me a lot to discover that the first time I came across this abuse of our brave men and women in uniform was way back in 2008, when I began with a brief vignette imagining what battlefield acupuncture might look like.

So here it is, nine years later, and nothing has changed. If anything, the infiltration of the quackery of battlefield acupuncture has infiltrated the military even more now than then. You might wonder where the reference to "Dr. Seuss monsters" came from. Don't worry. You won't finish this article without knowing, and it's truly mind-numbingly dumb, as one would expect from acupuncturists. In the meantime, let's see how this Stars and Stripes report starts out:

About 50 flight surgeons from 21 countries wrapped up a day of training at an international medical conference here this week with matching gold-plated studs set in their ears.

Their ears sparkled in the name of medicine: This was a hands-on workshop on battlefield acupuncture, an alternative therapy that’s vying to become a standard practice of care at Defense Department and Veteran Affairs medical centers for acute and chronic pain.

Battlefield acupuncture, a form of auricular or ear acupuncture so named because the tiny needles can be administered quickly in combat without removing so much as a helmet, has been around for more than 15 years.

But use of the technique, once practiced by fewer than a 100 military doctors across the services, is rapidly expanding through a vigorous training program supported by DOD and the VA.

This is stated as though it were a good thing. It's not.

Let's take a step back to when I first discovered the woo that is "battlefield acupuncture." The man most responsible for its promotion was Col. (Dr.) Richard Niemtzow, who is a radiation oncologist by training but, for purposes of this post, one of the foremost proponents of battlefield acupuncture. It should also be noted that "battlefield acupuncture" is somewhat different than regular acupuncture in that it is almost always primarily auricular acupuncture. Basically, the ears are the focus, and auricular acupuncture needles are considerably smaller than standard acupuncture needles. They're also sometimes left in place in the ear for up to several days, basically until they fall out. The idea behind this, presumably, was to come up with an acupuncture method that was easy and could be done under difficult conditions. Unfortunately, there isn't any actual science behind it. When you look at the studies presented in support of the practice, you'll inevitably discover that it's the thinnest of gruel, no matter how much advocates try.

None of this prevented the infiltration of "battlefield acupuncture" into both the military and the VA medical system. None of this stopped the military from deploying acupuncture-trained physicians to Iraq back when the war was still in full swing, with Army Rangers, of all forces, learning it and experimenting with it. None of this has stopped Col. (Dr.) Niemtzow from offering webinars, books, and courses in "battlefield acupuncture" or auricular acupuncture, which he now calls "rapid acupuncture," advertising them with statements like:

The medical mission is to provide the latest innovative acupuncture therapy techniques to patients who have not responded well to traditional Western medicine. Only those acupuncture techniques that have a very high success rate, usually successful during the initial treatments and are cost effective will be employed.

Nowhere is any compelling evidence presented that these techniques "have a very high success rate." There doesn't need to be. It's faith. “Auricular acupuncture” is based on a physiological principle that makes every bit as much sense as reflexology, and I mean that in the worst way possible. Basically, the idea is that parts of the ear "map" to parts of the body, like a homunculus. I was saying this nine years ago. Unfortunately, since then:

About 2,800 providers have been trained as part of the initiative, said Thomas Piazza, the director of the Air Force Acupuncture Program at Joint Base Andrews, Md.

In the Air Force, where the therapy was pioneered by physician and retired Air Force Col. Richard Niemtzow in 2001, close to 60 percent of its bases “are trained up” in battlefield acupuncture, Piazza said. “We’re looking to get battlefield acupuncture as part of standard of care versus a separate thing where we say ‘you can have an alternative medicine.’”

He added: “Sometimes people just want a Motrin and that’s fine, great, we’ve got that, too. But some people just don’t want to take medicines; they just want something else for a change.”

I did indeed cringe when I read that last quote, and you should too. Basically, it's a false equivalence in which a theatrical placebo (acupuncture) is represented as being just as effective as proven pharmacologic management and therefore, above all, an equally reasonable choice. That's what this is all about, normalizing quackery and, as "integrative medicine" proponents do, "integrating" quackery with real medicine, and now there are 2,800 military providers who have been trained in "integrating" just this form of quackery. It's a momentum that could well be unstoppable, because once you have thousands of people invested in a technique that technique tends to be offered, used, and, of course, standardized:

Piazza was at Ramstein last week to teach battlefield acupuncture to U.S. and NATO flight surgeons attending an annual international medical conference. One of the appeals of battlefield acupuncture is simplicity. The training is boiled down into a few hours of academic and clinical instruction. In one afternoon, the flight surgeons at Piazza’s workshop could find the five points on each ear — with names like cingulate gyrus and shen men — corresponding to where the needles go, in a particular order.

The training is standardized to ensure it’s done right, Piazza said. “Most of the people we’re teaching to aren’t acupuncturists,” he said. “We say follow this recipe, follow these steps.”

The cingulate gyrus? What the hell? That's a part of the brain, part of the limbic system thought to be involved with controlling emotional responses to internal and external stimuli (among other things). Is Piazza saying that part of the ear maps to the cingulate gyrus in the brain? Then, is he saying that sticking needles into that part of the ear somehow affects the actual cingulate cortex in the brain to block negative responses to painful stimuli? It's hard to interpret his claim otherwise.

Perhaps the funniest part of the article, which was undoubtedly not intended to be funny, was this:

Though side effects and risk of infection are minimal, Piazza told the flight surgeons that one of the hurdles they might face is convincing patients to try a treatment involving needles. “Who likes needles? Most of your patients don’t like needles.

“You’re going to learn this is much less painful than getting your ears pierced,” he said.

“It’s a little uncomfortable but it’s not like being shot,” said Col. Anthony Mitchell, an aerospace medicine resident at Wright-Patterson who was using the training as a refresher.

Yes. That's a ringing endorsement! Use battlefield/auricular acupuncture because it doesn't hurt as much as being shot. Well, even though I've never been shot (thankfully) and hope never to have that experience, I can't argue against the contention that having needles stuck in your ear doesn't hurt as much as being shot. What I can argue with is the implication that that this makes it OK to use a treatment that is quackery. Of course, in the article, Piazza throws out anecdotes and his personal clinical experience in which he stated that he used auricular acupuncture in Afghanistan in 2013 on wounded soldiers being transported to medical facilities as "an adjunct, to see if they didn’t need as much medicine." What he didn't say is whether that adjunct really did result in the wounded soldiers needing less medication.

Of course, this Stars and Stripes includes the usual trope used since time immemorial in articles discussing quackery of presenting the token skeptic view (in this case, that of Harriet Hall), followed by the quack retort:

Piazza said the therapy is backed by more than half a dozen randomized control trials and a number of case reports.

In one study, conducted by Air Force doctors at Nellis Air Force Base, Nev., and published in 2015, battlefield acupuncture was compared to standard pain treatment in 54 DOD patients with an acute sore throat. Acupuncture was associated with reduced sore throat pain for 24 hours and decreased use of pain medication for up to 48 hours. There was no apparent effect on hours missed from work.

Piazza said a group of doctors reported a 64 percent decrease in the rate of medical groundings for deployed pilots who received battlefield acupuncture instead of pain killers for lower back pain.

“We’re not looking to replace medicine,” Piazza said, but the procedure has been shown to reduce the use of narcotics.

Regarding the second claim, I could find no publications in the peer-reviewed medical literature to examine supporting it. Regarding the second claim, I looked up the actual study. (It's what I do.) Let's just say that the study is...underwhelming. Yes, it was a randomized controlled trial looking at 54 patients with acute sore throat. However, it was unblinded, a feature that renders any acupuncture trial pretty much worthless scientifically because it doesn't account for placebo effects. Indeed, it's a pragmatic trial. That means that the intent is to determine effectiveness under "real world" conditions; hence, no sham/placebo controls. In real medicine, pragmatic trials are used to assess the real world effectiveness of treatments already shown to be efficacious in randomized controlled clinical trials. However, given that auricular acupuncture has not been shown to be effective in such trials, doing pragmatic trials studying it is putting the cart before the horse.

Not that ever stopped acupuncturists from doing such trials before. After all, it's the way they generate "positive" trials. After all, doing rigorous randomized controlled trials with good shame acupuncture controls generally find that acupuncture is indistinguishable from sham acupuncture.

Earlier in this post, I said that the funniest thing I read in the article was the reference to the "cingulate gyrus" on the ear. I was wrong. The "cingulate gyrus" didn't invoke Dr. Seuss in a truly nonsensical way. Air Force Lt. Col. Patricia Macsparran did:

Air Force Lt. Col. Patricia Macsparran, the aerospace medicine consultant to the Air Force Surgeon General, incorporates acupuncture into her practice daily.

She’s a licensed acupuncturist with more than 300 hours of training.

She explains the science behind it with a reference to Dr. Seuss. When the body perceives pain, it sends a lot of fluid with anti-inflammatory products to fix it, she said. Under a microscope, those products “look a lot like Dr. Seuss monsters,” she said, and the body has a hard time clearing them out. “Acupuncture is sort of like a traffic cop,” she said. “If you know where to place those needles to push ionic flow to get things moving, you basically release that traffic jam so the body can heal itself.”

Battlefield acupuncture “is just scratching the surface,” she said. “Every organ in the body, including the brain, is represented on the ear. It’s a microsystem.”

Theodor Seuss Geisel is doing backflips in his grave. Or maybe not. After all, it's not the reference to Dr. Seuss monsters that's so dumb. I suppose certain immune cells could be described that way under the microscope. However, the rest is, without a doubt, the most ridiculous "explanation" for how acupuncture "works" I've ever heard, and, believe me, I've heard more contortions of science, hand waving, and pseudoscience than I can remember, but I've never seen an acupuncturist likening inflammatory products looking like "Dr. Seuss monsters" or likening sticking acupuncture needles into the skin as being like a "traffic cop" who "releases "ionic flow" to get things moving" so that the body can "heal itself. The entire passage above is what I like to refer to as "woo babble." It's like the technobabble that Star Trek fans (particularly Next Generation fans) are so familiar with, in which science-y-sounding terms are strung together as "explanations" to various phenomenon or used as a plot device to get our heroes out of trouble, only with woo instead. Oh, and Dr. Seuss.

Unfortunately, "battlefield acupuncture" is one small, albeit particularly egregious example of the "integration" of quackery into medicine, in this case military medicine. There is actually an active effort to normalize such quackery in medicine, but it seems to be particularly bad in military medicine, including the VA. It's being promoted by not just the military and the VA but by the National Center for Complementary and Integrative Health (NCCIH).

I've said it before more times than I can remember. Our men and women in uniform are putting their lives on the line in the defense of us all. They deserve the very best science-based medicine that we can offer. Unfortunately, there seems to be more enthusiasm for offering them quackery like "battlefield acupuncture" than actually improving the science-based medical offerings that benefit them. It's a scandal that no one's talking about.

oracknows Tue, 03/28/2017 - 21:00

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Medicine

"Dr. Seuss monsters"? Maybe she means macrophages, or some other phagocyte. But this is ridiculous. It's so ridiculous that it puts the U.S. armed forces to shame. Just because some military physicians allowed themselves to be duped by Chinese charms is no reason to expose the U.S. armed forces to the same practice.

What would Col. Potter say?

Before I forget, here's some fresh <A HREF="https://www.integrativepractitioner.com/whats-new/news-commentary/"<gri… for the mill. With so much to choose from, I would hardly know where to begin.

The military should pay more attention to voodoo acupuncture, the way to neutralize the enemy by sticking needles in toy soldiers.

When the body perceives pain, it sends a lot of fluid with anti-inflammatory products to fix it, she said. Under a microscope, those products “look a lot like Dr. Seuss monsters,” she said, and the body has a hard time clearing them out.

I would certainly like it if my body perceived pain, that would be great, but unfortunately it doesn't work like that and the pain all seems to happen in my mind where I can't get away from it. Anyway, like everyone else, I am keen to hear more details about these microscopic monsters. Do they look like this? Or this?

“Acupuncture is sort of like a traffic cop,” she said. “If you know where to place those needles to push ionic flow to get things moving, you basically release that traffic jam so the body can heal itself.”

That looks like an analogy, it has the formal structure of an analogy, but analogies are really supposed to make some sense and not be just some piece of stupid that fell out when a moron left her mouth open.

Suppose acupuncture is really more like a set of road cones?

I was at a course on regional anesthesia taught by the military several years ago. This topic came up, and when I came back to work I complained about it to my military CRNA. She did bring an important fact into the discussion about true battlefield conditions. She explained on the actual battlefield narcotics may need to be withheld so the soldier can continue to shoot his weapon and further defend himself until he can be evacuated. This is a scenario few of us have had to face or study.

Sticking needles in a soldier who needs to continue to defend himself seems, at best, counter-productive.

I think it particularly relevant that acupuncture is being used in the context of analgesia in battle.
Because that is what we...and by that I mean science based, reasonable people...are engaged in...not a battle, but a war against the ignorant world of pseudoscientific piffle. As a physician, I am completely aghast that such magical nonsense if being pushed onto people who need the very best that modern science and technology can offer. It just goes to show how dangerous it is when a purveyor of woo with vested interest gets into a position of influence. I hope to goodness we never see such nonsense being pushed onto the Australian military!

At least this is a field where Canada is thankfully lagging well behind. I thought it was bad enough that people could get a chit to go to a Chiroquackter, and be referred to a Nutritionist. I'm sorry, but when I was in the field, I wanted Ranger smarties (Tylenol, Motrin, etc) to damped the discomfort, not some idiot sticking needles in my ears. How the hell am I supposed to monitor the comms if I have needles where the headset rests? Granted if it's a thorax, abdominal, or head wound, the standard shot of Morphine is out, but acupuncture? Give me a break. Well to use the stereotype. It is an air-farce doc and not a real soldier promoting this.

@ Greg E
At the time of compulsory military service in France, people said: Military medicine is to medicine what military music is to music.

Having had a kidney stone or two I suggest the VA give all the vets who come in with severe pain from a kidney stone acupuncture instead of morphine sulfate or Dilaudid. When the patient figures out that he's/she's not going to get any real pain relief and climbs painfully out of the wheelchair to break the jaw of the idiot who prescribed the acupuncture maybe a light will go off.

Do an image search for "microscopic monsters". It really does look like a Dr Seuss fantasia. However, these wee beasties are mostly tiny arthropods and other parasites. Leukocytes can also look wild and shaggy under scanning EM. Not so with conventional light microscopy.

There's a reason "military intelligence" is on everybody's list of favorite oxymorons. That such a ridiculous idea as "battlefield acupuncture" wasn't laughed out of the room the first time it was suggested is an indictment of our military brass. You don't even have to know that acupuncture is bunk to see this. You don't even need to know more about battlefield medicine than you can glean from MASH reruns to see this (I am in that category). You need to evacuate the injured soldiers ASAP, and stopping to stick needles in their ears, even if it only takes a minute each, interferes with that. Those minutes can make the difference between life and death.

The first time this was proposed, all it would have taken is for one general to tel Col. Niemtzow something along the lines of, "This is the most ridiculous idea I have ever heard. Speak no further of it." Now, of course, it's too ingrained to eliminate that easily. But it should be, because this is more wasteful than a $600 hammer: At least you get a hammer for the taxpayers' $600.

In her Dr. Suess comment, Air Force Lt. Col. Patricia Macsparran obviously is referring not to inflammatory cells, but the Toxins released as part of the inflammatory process (and which TBruce is overlooking when he examines inflamed tissue under the microscope).

It's as obvious as Morgellons critters, and you don't even need to use the 40X objective.

I also routinely see ionic flow during my daily pathology work, and stage cancers according to their output of chi.
Get with the times, TBruce!!!

I don't...wait what?

What the hell does the appearance of microorganisms have to do with the means by which they are treated? Who cares if they look like Suess characters, Pokemon or microscopic Corgis? That is the dumbest thing I have ever heard within the realm of medicine, especially combined with my inference of the quote that she thinks magical-looking things must only be fought with her own brand of magic.

I read on another skeptic blog (I think) that acupuncture as practiced today actually has very little basis in TCM originally, and was mostly invented by a European guy who threw in the TCM angle as an appeal to antiquity crossed with an appeal to the exotic. So while the Chinese may have generated their share of woo, we might not be justified in blaming them for acupuncture, except to the extent that they fell for the con. The blame for inventing it may lie with the same sort of folks who gave us homeopathy.

The good news is, as of a couple of years ago, this nonsense wasn't actually being practiced on the battlefields of Afghanistan. This from a good friend of mine who commanded a nursing trauma unit at the UN hospital in Kabul, which is where the doctors all are.

i>While deployed to Afghanistan in 2013, Mitchell used battlefield acupuncture on wounded patients during air evacuation.

“This was just an adjunct, to see if they didn’t need as much medicine” during transport, he said.

While I don't imagine members of the military can sue for malpractice would there not be some way to charge a physician incompetence or malpractice for this under military law?

My doctor sent me to physiotherapy after I badly sprained my ankle last spring. Several weeks in the usual exercises and stretches were not having any measurable effect, so the therapist suggested acupuncture in my foot.
I let her try 2 sessions of it, but the only noticeable difference was an additional source of pain in the skin/muscles/tendons where she stuck the needles. I stopped going to physio altogether shortly thereafter.
Now, with a still painful and messed up ankle almost a year later, and an MRI showing tendon/ligament damage and a soft tissue mass in my foot, I am scheduled to see an orthopedic surgeon soon.
The acupuncture was clearly a waste of time. The physiotherapy wasn't much better.

Get with the times, TBruce!!!

I'd love to. What drugs are you taking?

Just because some military physicians allowed themselves to be duped by Chinese French charms is no reason to expose the U.S. armed forces to the same practice.

FTFY, as alluded to by Psalmanazaar above.

Hmm. My friend was there right around that time. She didn't know anything about it and had never heard of it. So it sounds like he was doing some kind of "trial" and I'll bet it wasn't successful. Military medicine is often cutting edge; if something works they start using it.

And no, you can't sue a military doctor :(. The government is immune from lawsuit.

What the hell does the appearance of microorganisms have to do with the means by which they are treated?

Viruses do not look like bacteria, and neither look like parasitic vectors like Plasmodium. Even within bacteria, they don't look alike. There are different treatments for these things, e.g., antibiotics don't work on viruses, and sometimes the appearance of a microscopic organism is a clue to what it is, e.g., filoviruses (Ebola et al.) have a rather distinctive appearance. Appearance is certainly not the only or even primary determining factor, but there are times it makes sense to consider it. And I'm not going to blast someone for attempting a layman's-level analogy like comparing these things to Dr. Seuss monsters.

Speaking of which: Given the image at the top of the post, a link to a YouTube video of Thurl Ravenscroft singing "You're a Mean One, Mr. Grinch" is obligatory.

While I don’t imagine members of the military can sue for malpractice would there not be some way to charge a physician incompetence or malpractice for this under military law?

The traditional way of dealing with an officer who repeatedly endangers their troops in a war zone doesn't usually involve a lawyer.

This is the sort of thing we can write our congressmen about. It's not a partisan issue, so they might just be able to pass some kind of law against it if we're lucky...

FTFY, as alluded to by Psalmanazaar above.

The French con-man who pulled the whole auricular-acupuncture scam out of his arse based it on a magical-thinking analogy between the structure of the human ear and the shape of the human fetus.
He may not have thought through all the implications -- like, how is this supposed to work when you extend the grift to the veterinary market?

The traditional way of dealing with an officer who repeatedly endangers their troops in a war zone doesn’t usually involve a lawyer.

But ISTM that this would be much harder to pull off against somebody in the Medical Corps. Much harder to simultaneously have the means and opportunity, while having some assurance that you will hit your target with minimal collateral damage.

I see this "working" in the same way that you hear stories about dentists on base who have lots of service members come through and insist on no anesthetic to prove that they're tough.

At the same time I am righteously pissed that DoD is willing to waste money on this, but there's no money at the VA for inexpensive programs to reduce HepC.

What I don't get is, when did the US Air Force begin treating sore throats with narcotics and now, acupuncture?
Seriously, terpin hydrate with codeine was removed from the national formulary in the 1990's because there was no evidence that the crap actually worked.

As for battlefield acupuncture, thankfully, my teams were never subjected to that. We stuck with that which is proven to be effective for pain management, morphine 15 mg IM and rapid evacuation of the casualty.
We had two innovations that also proved highly effective, air ambulances had blood on board, which saved thousands of lives and the other innovation was bringing back the tourniquet.
The US Army originally trained that once a tourniquet was used, the limb was lost. Right until a physician fought against that idiocy, observing how long orthopedic surgeons have a tourniquet on a patient who is undergoing surgery. Now, every service member carries their own field dressing and tourniquet.

Seriously, if that Colonel would've come up to my team and suggested plying his needles, I'd have retired two pay grades lower in rank. That's because, he'd get no due respect from me and he'd be instructed quite firmly on where he could stick his knitting needles.

I imagine the field medics wouldn't bother with this. They really would be the ones to do it. Once they get to the field hospital, the staff have other things to think about than acupuncture.

I can't help but wonder if the military docs are just using this "training" as a free day off with travel.

One gets one's CE units where one can find them.

Pity that they didn't replace that training with something useful, like treating hydrogen fluoride inhalation injury.
http://militarymedicine.amsus.org/doi/pdf/10.7205/MILMED-D-11-00165
http://ets.fulton.asu.edu/files/shared/Treatment_of_HF_Exposure.pdf

The second document is now the golden standard for such injuries. That's because in Afghanistan, the new mine resistant vehicle (MRAP) fire suppression system was targeted, resulting in the halogen fire suppression system being triggered and the suppressant being superheated by an RPG round, which then degraded to HF, which exposed the vehicle occupants to inhalation injury.
Calcium Gluconate is now available for ambulances, including an form that is administered by nebulizer.

Oddly, that innovation has saved lives and still does not involve sticking pins in service member ears.

Wzrd1: I thought the standard treatment for sore throat was water<tea with honey< milkshake/popsicle < straight honey.

Then again I know a Marine who didn't sleep for two days because the sore throat he had from mono woke him up every time he swallowed. Then again, that was college, which is the same as "terrible home care".

Personally, I'm partial to honey and lemon. It's quite soothing and chilled, even more soothing.
Or saline gargles with hypertonic saline solution.
The latter also helps with a toothache, which of course, only occur on holiday weekends.

Yeah, EPV infections can be quite painful, although most don't get such severe symptoms.

Actually, I wonder if any of the attendees sporting newly pierced ears were men.

According to this link,
http://air-force.com/info/uniform/general

they are still prohibited for men.

Members are prohibited from attaching, affixing or displaying objects, articles, jewelry or ornamentation to or through the ear, nose, tongue, or any exposed body part (includes visible through the uniform). EXCEPTION: Women are authorized to wear one conservative, diamond, gold, white pearl, or silver pierced, or clip earring per earlobe.

According to The Balance
https://www.thebalance.com/air-force-policy-on-tattoos-piercings-3331719
this also applies to men off duty on military installations.

Wzrd1: interesting article. Nebulized calcium gluconate. Love it :)

Shortly after the medical team that was emergency dispatched to Afghanistan to treat these victims (too unstable to transport out of country) developed that protocol, four more victims were transported for treatment.
And the protocol was ignored in favor of more rapid transport. :/
Well, until they hit the field hospital, where it was initiated.
All survived that attack.

any exposed body part (includes visible through the uniform)

Nipple rings are fine. Good to know.

Now you tell me, after I'm retired!

Updated mental image of Wzrd1:
http://2.bp.blogspot.com/-QxPYwveUOKI/TgpPLJtdUzI/AAAAAAAACO0/28ylzfRvz…

I've far more corrosion than that.

RE: herr doktor #37
http://i2.kym-cdn.com/photos/images/original/000/427/123/d71.jpg

Egads I thought our conversations were to devolve into food. This is what happens when the menz are left to their own devices.

Food? Sure, I'll play.

I picked up one of these last week
https://anovaculinary.com/anova-precision-cooker/

I'm still learning. Dunno if I like it yet.

I do real well low and slow on the smoker, and hot and fast on the grill. This is... different. No fire.

That certainly looks intriguing. That might help me a bit when I make a couple of gallons of pasta sauce.
Immersion circulator, there are a bunch of companies that make similar units.
They look easier to figure out than that Brother sewing machine I just bought. ;)

I've had pretty good luck with my NuWave Burner, using it like a sous-vide machine. Set it for the temperature you want and forgot about it. Nothing can overcook that way.

I never thought about cooking meat in bags, though. Do you brown it first? Or afterwards?

From what I saw (and how I'd do it to keep texture), after cooking is when one browns the meat.

Maybe you could use a little blowtorch like on a creme brulee--there we are: Cooking completely re-invented!

Browning afterward seems to be the standard recipe. Otherwise the brown crunchy bits would be brown, but soggy.

My original thought was to use it for fish and other seafood. I've done swordfish a coupla times, but it seems underdone. I need to up the cooking temp, I believe.

I've reheated deep frozen pork shoulder and it was OK, but it was done, sure (it was done when I froze it), but it wasn't really as good as it could have been. Again, I think it's a temperature problem.

Dunno how it would fit in making a gallon (or more) of red sauce.

My next try is potatoes. Bag up some spuds, butter, a bit of EVOO, and some spices, put it on the (almost) boil, and come back after a while. We'll see.

Johnny, there are the size you spoke of and purchased and larger, commercial sized units.
If my research hits good enough paydirt, I'll sink in $2k for a large unit. It'd be worth the lowered stirring time to me.
I typically make two gallons of pasta sauce a month. Scorching is a problem, due to the nature of an electric stove and a thin walled pot, not to mention single source at the bottom heat.
Stirring helps lower it, but lacking a two gallon flask and chemical heater/stirrer unit, I'm at an impasse.
Unfortunately, I had work to keep me from proper deep research, now it's my "weekend", so once I fix a major database problem with my MythTV server I just rolled together, that'll hopefully be trivial research.

Honestly, this is a first learning of these devices, although more primitive devices are intimately familiar to me.
http://www.gr8gear.com/genuine-issue-m67-immersion-heater.html#.WNze71X…
Quite familiar. I've frequently joked with unit cooks about a 21 gun immersion heater salute.
They operate on gasoline dripped onto a cast iron plate, flooding the unit at the right time *would* result in both a launched chimney pipe and any aircraft nearby receiving a missile launch warning.

And no, you can’t sue a military doctor :(. The government is immune from lawsuit.

There are a few moving pieces here, but sovereign immunity doesn't extend that far, because of the Federal Tort Claims Act (you have to sue the government rather than one of its employees). The military is instead shielded by the Feres doctrine (to wit).

^ Upon reflection, "instead" was probably too strong a word, but I'm too tired to review the official-duties part of the FTCA.

I hate that our military is subjecting soldiers to acupuncture and just saw that Norton Children's Hospital (formerly Kosair's in Louisville, Ky) is now offering acupuncture for kids. The head of the department is Mark McDonald, M.D. who is a pediatric critical care doctor by training and so has no excuse.

Sadly, Col.. Potter approved the use of acupuncture to treat Major Winchester's back pain--and it was shown as effective. The MASH episode was titled (ironically?) "Back Pay."

Does anyone know who is actually behind this? I noted weeks ago that the Revolution4TRUTH website didn't have an "About Us" page and only listed a few, lame anti-vaccine clubs as supporters. Even on their "Donations" page you can't find out who you are donating to. They may be sending a check to Charlie Manson in his cell for all they know.
Yes, I'm aware that all these anti-vaccine clubs are all run by the same small group of grifters who create new "Organizations", with membership = 4, whenever the need arises.
But, who is actually the person behind this? Who thought it up? Who is running it? Who is the head honcho(s)? Who gets the "donations"?
Anybody know?

I'll also note that missing from their pathetic list of speakers is one Andrew Wakefield.
It seems that it has finally dawned on them that Wakefraud is box office poison outside their cloistered little anti-vax bubble. He's very good at rousing the party faithful and picking their pockets but in the outside world he is considered the Bernie Madoff of science and medical fraud. Well... there was probably an important UFO conspiracy convention this weekend that he and Polly had to attend.

This does seem to be more geared to the True Believers™ since most of the speakers are so obscure that they will be known only to those who dwell in the anti-vaccine cult's info-bubble.

Sorry, the above comment was meant for today's article, not this one. That's what I get for having 2 tabs open at the same time.

Sorry Orac and please delete this and the above.

I was hoping you were going to pick this up Orac, as I saw it in the Stars and Stripes myself. Sadly, that was in the lobby of the Middle East TMC where I am currently serving as a deployed PA and yes, this crap is full-blown at this installation.

One of the IM docs also specializes in "integrative pain management", so this is huge here. Worse, unlike most modalities he uses, this one is easy to teach, so he trained a bunch of other PAs and MDs how to perform it and got them "certified" as battlefield acupuncturists. There is supposed to be another training in the next 6 weeks or so, and I am sure I will be expected to attend. There is a lot of demand for it by the patients, and judging by the reaction I got for merely suggesting I was skeptical of the utility, I just keep my head down now.

I will say, seeing to one of the Ortho surgeons (a DO no less) stand up in a clinician meeting and tell the primary driver of nonsense to go pound sand about myofascial release one day was pretty glorious though.

Copyleft@52: But that's not nearly as ridiculous as the battlefield acupuncture being promoted in our military today, for two reasons:
1. Unlike certain other forms of woo (such as homeopathy or reiki), acupuncture has an at least superficially plausible causal mechanism, and the research showing that it doesn't work hadn't been done yet.
2. The treatment takes place behind the lines, not on the battlefield, so the practitioner can take the time to use best practices. It's not like the treatment was delaying Winchester's evacuation to a hospital.
Also remember that Col. Potter was regular Army, so he himself had no medical training beyond (presumably) basic first aid. Admittedly, Maj. Winchester did not have that excuse.

Col. Potter was a fully qualified surgeon on MASH. He was frequently portrayed operating with the rest of the surgeons. In fact, he was admired by the other surgeons for his skill.

Reality (#53) writes,

Sorry, the above comment was meant for today’s article, not this one. That’s what I get for having 2 tabs open at the same time.

MJD says,

Beer Tabs?

At least your honest about it, Reality.

Col. Potter was regular Army

Potter was regular Army in contrast to Col. Blake, the first CO in the series, who, like most of the characters, was there because he had to be. Both were considered bona fide surgeons. The one who was portrayed as bumbling was Frank (Major Burns), whom Winchester replaced.

In another MASH episode they ran out of pain killers and Col. Potter has the unit use placebo pain killers (sugar pills). Potter tells everyone the only way these pills will work is if we sell the idea to the patient (theatric placebo).

Last night, my subconscious kept trying to stitch together some narrative involving "Dr. Seuss Monsters from the Id", a la Forbidden Planet. Thanks, Orac!

Wzrd1 @47 I've got an ANOVA and I'm pretty sure if you tried to use it to both heat and circulate pasta sauce all you'd do is destroy the heater/circulator. It's only meant to heat water.

So far I haven't found anything to do with my ANOVA that's revolutionary. I haven't liked the short ribs and the potatoes were a little underdone (which was probably because they started cold not room temp). I did successfully pasteurize some eggs to make mayo for company (I don't take chances with other people's little kids).
I've heard that you can use an immersion circulator to de-activate the enzyme in avocado that causes browning, but I haven't tried it yet.

As I said, there are commercial models, designed more like trash pumps than water pumps. But, those cost in the thousands of dollars range, so I'll not likely be experimenting with them.

Theatric placebo can work. The problem is it doesn't always work, and lying to a patient is unethical.

When I worked as a correctional nurse, the physician I worked for would prescribe "Cebostat" to the drug seekers for their "chronic pain" (this was before the explosion of prescription opiate abuse). They were placebos, sugar pills. It was a "shut 'em up" prescription since the jail discouraged the use of opiates without a clear medical indication.

These guys would come back to jail and beg for "Cebostat." They'd tell me how much better it was than Vicodin.

The placebo effect can work. It's just not ethical, and it's not predictable or reliable.

I’ve got an ANOVA and I’m pretty sure if you tried to use it to both heat and circulate pasta sauce all you’d do is destroy the heater/circulator.

Statistical software is powerful, but not that... Oh. Different ANOVA.

HDB: Soon enough I'm sure we'll see someone use an ANOVA to do some kind of study where they'll use ANOVA to analyze the data, just to get a funny title on their paper.

@JustaTech, well, it would make for excellent random number generation. ;)

US bloggers xenophobia concerned the Chinese have taken over the US military!
His bible and patriotism made him write this blog!

It appears that someone decided to read only the title and not a word of the blog itself, then comment out of pure, sheer and unadulterated ignorance.

Ease up on the Foster's, mate.

"I typically make two gallons of pasta sauce a month. Scorching is a problem, due to the nature of an electric stove and a thin walled pot, not to mention single source at the bottom heat.
Stirring helps lower it, but lacking a two gallon flask and chemical heater/stirrer unit, I’m at an impasse."

Have you tried starting on the stove top then finishing in the oven? Just pour into a Non-reactive roasting tin, cover with foil if you don't want evaporation, no foil and stir every 30mins if you do, and leave on the lowest setting.

If you want to get really fancy use the roasting tins to setup a Bain Marie with some smaller containers.

Also IIRC Alton Brown used a cast iron skillet as a very good heat diffuser if you're desperate

A pot that holds two gallons is a wee bit larger than most cast iron skillets or roasting pans. :)

But a large roasting tin can hold 2 gallons, or just split between two.

Really large roasting pans like that tend to be significant scald hazards when moving out of an oven.
I'll stick with the deep stock pot, which won't slosh out and leave me badly scalded. :)

Wzrd1 and Mongrel: I'm pretty sure my stockpot would fit flat in my cast-iron skillet, so I can see how that would work.
I've also made apple butter in my roasting pan (really the only way I would make apple butter, otherwise it's a splattery mess).

I have seen an attachment you can buy that fits on top of a pot that stirs automatically. As I recall I saw it on a list of "things that don't really work" but I would think with a good amount of fiddling you could get something like that to work. Maybe even wind-up so you don't have to worry about electric cords?

Quackery at the VA: Our veterans deserve real medicine, not fake medicine

oracknows — Fri, 27 Jan 2017 06:00:48 +0000

Quackery at the VA: Our veterans deserve real medicine, not fake medicine

I get e-mail.

Often, the e-mail I get consists largely of rants from various cranks about how I am a "pharma shill" and whether I feel any regret over the babies I'm supposedly turning autistic by my advocacy for vaccines. Much less often, I get e-mails praising me for my work. Sometimes, I even get e-mails that tell me that my blogging was the reason someone turned away from the dark side of antivaccine quackery or other pseudoscience. Those e-mails make my day.

I also sometimes get e-mails like this:

I'm in the VA healthcare system in Los Angeles. I had previously read your article about how 'alternative medicine' is creeping its way into the VA system.
I was referred to the "healing touch" "nurse" because an actual physical therapy appointment takes three months to get. At first I thought this was some massage technique and would help relieve some muscle tension in my shoulder. Well come to find out it they put me in a room with traditional Asian-themed relaxation music and enough aromatherapy that I felt like I was in a nail salon.

She began to tell me how the "energy of the universe" flows through her hands and because of her touch, many many people have had their lives changed. So I guess sort of like the television church shows but this is taxpayer money.

After about 5-10 minutes of anecdotal stories and claims that there have been "studies" that this works, she proceeds with the "treatment" which basically involves her putting her hands on me and saying she is "feeling" that I have had pain in areas. She goes down a list of stomach, leg, back, neck, headaches, anxiety, etc. saying she can "feel this." More like she can read my VA file which is in the computer. Even then she is 50% correct about my problem areas which I can also replicate with a coin toss.

At the end she asked me how I felt and I told her I felt the same. Then she said that it's a "cumulative effect" and that the "healing energy" needs to build up in my body. "Remember to drink a lot of water for 24-48 hours because the energy is still in your body." Unbelievable! I was polite and smiled, but I wanted to scrutinize this so bad.

Normally you could chalk this up to Los Angeles and how we have this anti-science subculture here, but this is the VA. And tax dollars are paying for it. To add insult to injury, these monies spent on crap like energy healing also make it where I can't get the care I need from REAL doctors and physical therapists due to lack of funding.

Just wanted to give you a first-hand account that this quackery has fully made its way into the VA healthcare system. Thanks for the great website and teaching me a lot about science and medicine that would otherwise be more difficult and less entertaining to read.

Later in the e-mail exchange, he said:

By the way, they are also offering acupuncture at the West LA facility and I was offered this to treat migraine headaches. I told them my concerns (info i got from your site actually) that through studies they found that it's entirely placebo and I was wondering if they had any additional evidence. This doctor, who I actually believe is a real doctor, told me that they had been shown evidence that people felt a lot better. I responded with "Well, it's also been documented that when a doctor asks how your day was and demonstrates they 'care' then patient outcomes improve big a noticeable margin as well. So how is acupuncture different than that?" Her response was something about nerve pathways, etc. At least she didn't tell me something about Chi or I'd go nuts. Again, taxpayer money diverted to quackery instead of things that are proven to help and have science to back it up.

I've written on numerous occasions about how quackery (or, as I like to call it now in the age of Trump, fake medicine) has infiltrated military medicine and less frequently about how the same thing is happening in the VA medical system, but there's nothing like an actual personal anecdote to make it really real to me, which is exactly what this anecdote did. Healing touch is a form of "energy medicine." In contrast to reiki, where the reiki master claims to be able to channel "healing energy" into the patient from the "universal source," practitioners of "healing touch" claim to be able to manipulate the patient's "energy field" to produce healing and/or relieve symptoms. I approach these stories from the viewpoint that our veterans deserve the best medical care available, and that that medical care is science-based medicine. "Complementary and alternative medicine" (CAM), "integrative medicine," or whatever the nom du jour is for the quackery masquerading as "wellness" or "holistic medicine" that is currently infiltrating civilian hospitals as renowned as The Cleveland Clinic should have no place in military medicine or the VA either.

In other words, our veterans deserve real medicine, not fake medicine integrated with real medicine.

Spurred by my reader's anecdote, I did a bit of Googling. In addition to finding the usual stuff, such as a VA web page about CAM use for post-traumatic stress disorder (PTSD) that says that there's only "limited evidence about the effectiveness of CAM as a treatment for PTSD" but notes that "89% of VA facilities offered CAM and 1% were in the process of developing CAM programs" and that a recent survey of all 170 specialized VA PTSD centers showed that 96% of respondents offer CAM for PTSD.

Then there was this gem of an article published last year in The Journal of Alternative and Complementary Medicine by a couple of heavy hitters in the world of integrating quackery into medicine, including Richard C. Niemtzow MD, PhD of the U.S. Air Force Acupuncture and Integrative Medicine Center, Malcolm Grow Medical Clinics and Surgery Center, Joint Base Andrews, MD, as first author and Wayne B. Jonas, MD of the Samueli Institute as well. We've met both of them before, particularly Dr. Niemtzow, who is best known for wanting to bring acupuncture to the battlefield. (No, I'm not making this up.) Jonas, of course, is the President and CEO of the Samueli Institute, one of the foremost proponents of integrating fake medicine into medicine.

Along with the usual drivel about how acupuncture is ancient and effective (it's neither), Niemtzow et all note:

Acupuncture is well known in Eastern cultures for its analgesic benefits. Many medical practices in Western countries have focused not only on this modality but on other integrative approaches to combat pain. As addiction to prescription opioid medication is skyrocketing in the United States, Western physicians are rapidly exploring the benefits of acupuncture for the relief of pain. In particular, BFA, which uses a specific sequence of five ear points for rapid pain relief, is the most popular and “go-to therapy” utilized by military medical acupuncturists around the globe. This is because of its history of providing rapid, safe, and effective pain relief in wounded warriors over many years. As a consequence, and also influenced by the APMTF, a $5.4 million DoD–VA Joint Incentive Fund (JIF) project—“Acupuncture Training Across Clinical Settings (ATACS)”—was funded by the DoD–VA Health Executive Committee in April 2013. The ATACS Program provides BFA [battlefield acupuncture] instruction to DoD and VA healthcare providers (HCPs) and gathers relevant information to ascertain its impact on pain and, in particular, its ability to reduce opioid use.

Successful implementation of an IM [integrative medicine] program by any healthcare system requires a disciplined multistep process. The first step involves selecting a modality that is evidence-based, safe, and has the potential to demonstrate its value in achieving desired outcomes. Selection of appropriate modalities may be ascertained by a combination of a review of available clinical trials, published literature, and/or by empirical clinical experience. Such was the argument for BFA. A second key step, particularly in a large and/or complex healthcare system, is to ensure that HCPs receive a systematic and standardized training program from experienced and well-qualified instructors. This is particularly critical when rolling out an IM modality, for which practitioners may have never been trained.

See what I mean? There is an active effort to train HCPs in the VA in acupuncture and to promote fake medicine under the guise of real evidence-based medicine. As much as advocates claim that acupuncture is evidence-based, it's just not. It's a prescientific medical modality that is rooted in vitalism and nothing more than a theatrical placebo, with the "best" clinical evidence indistinguishable from the normal "noise" in clinical trials that occasionally produces false positive results. Of course, CAM advocates don't like it when it is pointed out that acupuncture is fake medicine. Unfortunately, because acupuncture involves sticking needles into the skin, many physicians think there might be something to it, leaving aside all the mystical mumbo jumbo. Certainly, a decade ago I was in that group. Heck, even someone I admire as much as Paul Offit fell victim to the acupuncture narrative in an otherwise excellent article on quackademic medicine by seeming to argue that it is more than a placebo and citing the "endorphin" explanation, even as he got it right that it doesn't matter where you stick the needles in or even if you stick them in. That's how powerful the narrative can be.

Reading e-mails like my readers angers me. Remember, the reason he was referred to a "healing touch" quack is because the wait for a physical therapy appointment was three months, which is an unacceptable length of time. In other words, the Los Angeles VA doesn't have enough physical therapy resources to meet the needs of its veterans, but it has energy medicine quacks willing to fill in the gaps. I can't help but wonder if this situation comes as a result of the failure of the federal government to invest enough resources into the VA Medical System. More physical therapists and fewer quacks, I say! Unfortunately, since the VA hired Dr. Tracy Gaudet as director of the VHA’s Office of Patient Centered Care and Cultural Transformation, fake medicine has become increasingly entrenched (or should I say "integrated") into the VA. Naturopaths are even now lobbying to be employed by the VA. Nothing has come of their efforts that I'm aware of thus far, but if there's one thing I know about naturopaths, it's that they're persistent. They'll keep trying.

With all the problems the VA health care system has, shortage of resources and long waits have always been among them. Unfortunately, in response to the shortage of real medicine, the VA seems to be taking a page from the Mao-era Chinese playbook and trying to "integrate" fake medicine with real medicine to paper over the problem.

Our veterans deserve better.

oracknows Fri, 01/27/2017 - 01:00

Categories

Medicine

Your correspondent has every right to be unhappy about the state of affairs. "Healing touch" is so obviously ridiculous that a then nine-year-old girl saw through it, did a study as a science fair project, and got the study published in a leading medical journal. Why are we spending taxpayer money on such nonsense, especially when doing so prevents our veterans from getting real healthcare?

Doesn't this sound like China in the 1950's? Too poor to provide real medical care, that government fobbed off the peasants with minimally-trained practitioners of traditional Chinese medicine. The present-day VA, too poor/understaffed to provide timely physical therapy, fobs off the veterans with minimally-trained practitioners of hand-waving, er, therapeutic touch.

Successful implementation of an IM [integrative medicine] program by any healthcare system requires a disciplined multistep process. The first step involves selecting a modality that is evidence-based, safe, and has the potential to demonstrate its value in achieving desired outcomes. In other words, send in the clowns, starting with long-nosed ones first.

Talk about a nightmare of Fractured Fairy Tale! Like so many other products from China, such as the fake parts installed in U.S. Air Force jets, the fakery of acupuncture and other pseudoscientific nonsense parading as medicine is placing the health of America's military personnel at serious risk. Not a dime should be wasted on any of it, unless the expense is for its outright ban and removal. And naturopaths? I wouldn't trust anyone of them to apply a bandage, let alone treat a veteran. But it's not just the veterans; we all deserve better and effective treatment.

Is there any reason, any at all, while the “richest, most powerful nation on earth” (as we so often hear) cannot fully fund the VA? I really would like an answer to that one, especially given that every politician wears a flag on the lapel these days--even before the current clown act.

What’s most disturbing about the veteran’s letter to you is that the doctor defended the acupuncture with the “nerve pathway” nonsense. Doctor’s need to know better and get off those fences they’re perched on.

@ darwinslapdog
“richest, most powerful nation on earth”, not anymore.
https://www.youtube.com/watch?v=XAziFqgmH_Y
Maybe in a few years, they'll get real medicine.

@darwinslapdog: It's because many of the politicians who wear those flag pins on the lapel are only doing it for show; they don't really care about the soldiers. It's hardly a new phenomenon:

You talk o' better food for us, an' schools, an' fires, an' all:
We'll wait for extry rations if you treat us rational.
Don't mess about the cook-room slops, but prove it to our face
The Widow's Uniform is not the soldier-man's disgrace.
For it's Tommy this, an' Tommy that, an' "Chuck him out, the brute!"
But it's "Saviour of 'is country" when the guns begin to shoot;
An' it's Tommy this, an' Tommy that, an' anything you please;
An' Tommy ain't a bloomin' fool -- you bet that Tommy sees!

What frustrates me is the VA's funding problems are inflicted by Congress. They keep cutting the budget and failing to fund mandates. Then they blame managers who try to make Congress thing everything is OK when it's not . . . .because of Congress!

That's because Paul Ryan would like to privatize the VA just as much as he wants to privatize Medicare. So when the VA "fails" because Congress doesn't fund it, he can claim the VA is "broken" and the only way to "fix it" is to privatize it.

Which is not what our veterans want. They like the VA and want to keep it.

As a nurse and a veteran this infuriates me.

I'd love to know what this "therapist" was paid. A local children's hospital has a kook doing this in the hospital but at least there is no charge for her quackery.

I wonder how long it'll be before "Asian-themed relaxation music" is mandated in the O.R. (I've heard various music being played in there, but none devoted to enhancing Healing Energies).

As far as cancer centers/institutes go, are there any otherwise respected ones that do NOT promote some form of this nonsense (i.e. healing touch, reiki etc.)?

It's fairly uncommon. I can say with some pride that the amount of that sort of stuff at my cancer center is much lower than it is at much bigger, more famous centers, like M.D. Anderson and Memorial Sloan-Kettering. There's a smattering of it around, but we have no formal integrative oncology program. That makes me happy. I guess that's one advantage of not being where I am now. However, I'm always waiting, always on my guard that, sooner or later, someone will get the bright idea to set up a formal integrative medicine program here.

Honestly it should be privatized. The problem is when the government is controlling the entire system it becomes easier for lobbyists and special interests, such as alternative medicine groups, to influence decision making that affects the entire nation. Allow competition, and every facility is pushed by competition or the chance of competition to appear to be as effective as possible.

Corollary to that point: laws should exist to declare charging patients for nonscientifically supported medicine as fraud. And the standard for scientific support should be from scientists, not the government.

The Cleveland Clinic is a private institution, and that didn't stop it from fully embracing fake medicine in its Wellness Institute. There is a big private hospital in my area that's done the same. It's arguably easier (and more tempting) for private hospitals to embrace woo because it's seen as a potential profit source, without all that nasty mucking about with insurance reimbursement.

Privatizing the VA would not fix the woo problem. There's an argument to be made that privatizing the VA would have the potential to make the woo problem worse.

Doesn’t this sound like China in the 1950’s? Too poor to provide real medical care, that government fobbed off the peasants with minimally-trained practitioners of traditional Chinese medicine.

A key difference: 1950s China did not have the resources to deploy fully trained doctors throughout the country. Mao decided instead to deploy TCM practitioners in the countryside. There are plenty of reasons to disagree with that choice, but in context I can understand why it was done: better a placebo than nothing at all, at least from a typical patient's point of view.

The US does have sufficient resources to provide adequate medical care to everybody who wants it. The issue in this country is a lack of political will: providing health care costs money, and too many politicians would rather put that money toward reducing taxes for wealthy donors to their campaigns. (There are lots of other things that I would consider better uses of that money than tax cuts for rich people, but I digress.) So the VA gets shortchanged.

@Zach #11:

Honestly it should be privatized.

Yet here in the UK we have a system which mostly eschews this drivel, because there is a central demand for cost-effectiveness which isn't reliant upon insurance companies' profits. Our system has its faults, as all do, but at least we can all get access to healthcare without having to go bankrupt. There may be regular political interference in terms of emphases of outcomes, but even our current Secretary of State for Health apologised for his personal beliefs about homeopathy once the issue was described to him in full. Can you imagine a Trump appointee doing that?

@11 Zach

Privatizing it would work as well as all the other hospital privatizations that have occurred in the US. Costs go up, and profits go up, and care is second place to all of the above. I have issues with the Canadian Health care system (Too much administration and not enough physicians, Provincial in-equality in coverage and care, wait times, etc), but for all that, all Canadians are a lot better off than all but the wealthiest Americans. We should have our prescriptions covered by the government as well, but even so, no-one goes bankrupt because of illness. Well no-one who isn't paying for rank BS like the Deathness Centre in Florida or Burchin-ripyouoffs quack centre in Texas.

This pisses me off so much. The VA doesn't have money for PT but they have money for a hand-wiggler?
Story time: For one of my MPH classes we had to design programs to implement in the facilities we work in (it was a program planning class). My partner (VA shrink) and I developed a peer-education program to reduce HepC infection rates among injection drug using vets.
The program we designed was based on scientifically designed programs to prevent HIV infection (called SHIELD), and as it's a peer-education program it would have been relatively inexpensive to implement.

We did a ton of work and research, got a great grade, sent it to his superiors who were like "nope".

No to preventing HepC infections, but they have time for "energy healing"? That's some grade-A BS right there.

I served from 1982 until 2009 and watched the VA budget get cut each and every year, counting the first year of the wars in Iraq and Afghanistan.
I've watched Congress divert money from the VA into private practices, which were utterly unqualified in dealing with veteran specific issues.
I've also watched the VA spend, or I should say waste, millions of dollars in ineffective TENS units, while never having enough flotation beds, requiring a board to approve each patient who could be assigned to one, pressure ulcers not withstanding.
Each and every year, we hear politicians tell us that veterans are number one, but we ignore the fact that it's the third digit being raised toward veterans causes and needs.
We know how this administration feels toward veterans, as quite well illustrated by federal hiring freeze, which will guarantee that the VA medical system remains understaffed.
But, with less people, we'll just get more ineffective woo, rather than real treatment.
In short, SSDD.

Anyone else getting a weird vibe that all this new "Integrative Medicine" is really just old "Paternalistic Medicine" making its comeback in a hip new patchouli-scented coat; much as Post-Modernism proved to be nothing but all the Pre-Modernists exacting their revenge?

Or is it just my chi needing rebalanced again?

I dunno about your chi, but my energy needs replenishing.
Fortunately, the chicken is in the oven, the veggies on the stove and the potatoes will go into the oven shortly.
Hey, food delivers chemical energy to the body. ;)

Eric Lund's post @ #6 reminded me of the song, Brother Can You Spare a Dime. Here's a passage:

Once in khaki suits, gee we looked swell
Full of that Yankee-Doodly-dumb
Half a million boots went sloggin' through Hell
And I was the kid with the drum
Say, don't you remember, they called me "Al"
It was "Al" all the time
Why don't you remember, I'm your pal
Say buddy, can you spare a dime?

@Anonymous Pseudonym #15: A Canadian just sent me a link to an article about the dismal state of affairs in senior care homes in B.C. By allowing private contractors to flip contracts and hire fewer people at poorer rates of pay, the government of B.C. has managed to erode the care of seniors to the point that 90% of facilities now fail to meet staffing requirements. Placing more stress on existing staff while threatening the health of the seniors may be profitable for the scum-bag contractors, but it's a recipe for disaster.

has@18: I'm not qualified to assess the status of your qi, but you may be on to something there. Homeopathy admits to being "only" a couple of centuries old. A lot of the cow pie portion of "integrative medicine"'s cow pie-apple pie blend is claimed to be thousands of years old, even when it isn't (TCM and reiki being two such, "ancient" systems dating all the way back to the 20th century, and in the case of TCM the latter half of the 20th century). What "integrative medicine" and pre-scientific medicine have in common is an emphasis on bedside manner; neither has much else going for it.

No to be crass, if I was offered "healing touch 'therapy'" in a hospital or other medical facility, I would be happy to tell the therapist exactly what kind of touch would make me feel much better, and I would tell the acupuncturist where to stick the needles.
Either of those would make me feel better and raise my endorphin levels.

I was a clerk in a VA hospital in the '70s. The hospital itself looked kind of ugly, but I saw many competent and caring physicians , PAs, and nurses. (The psychiatrists were kind of weird, but the patients loved them.) I used to take my father to an outpatient facility where they offered him care for problems he had never thought about. including PTSD, and two hearing aids and 10% disability for hearing loss due to combat. He was very happy with the care he received there. All this was after the scandals during the Vietnam war when it was clear the VA was operating very poorly, much worse than the recent problems.
I am bothered by what is going on now. The docs I knew there would never have put up with this kind of nonsense.

Lighthorse,that song was a pointed reference to the Bonus March of 1932. World War 1 veterans had been given certificates that would be redeemable in 1945. With the Depression in full swing, many were in dire condition and wanted the payout immediately. Thousands camped out on the Anacostia Flats in DC with their families. President Hoover, running for reelection, wanted to show a firm hand to those Communists (Reds under the bed scares were not invented in the 1950s.),
He gave carte blanche to Army Chief of Staff Douglas MacArthur and his aide, George Patton. MacArthur claimed that they were there to overthrow the government. Those two lovelies went all out - cavalry swinging sabers, tear gas, bayonets. Tanks crushed their tents and shanties which were then burned. There were a few deaths and many injuries. Men who had served under Patton and MacArthur in France were there, and before the assault, some attempted personal appeals to no avail.
It played a significant role in Hoover's defeat that November.

Thank you, ORD, I have learned something new today.

@21 Lighthorse

It's great when the government abdicates its responsibilities. There's been a recent report on a nurse at some nursing homes in Wood-stock, Ontario who has been helping the residents off to the nether-realms (http://www.cbc.ca/news/canada/windsor/woodstock-nurse-first-degree-murd…). We have our issues with the Public health-care system, but it is no-where near as dysfunctional as the US system. It's also no-where near as good as the UK's or Norway's medical care. As I mentioned, it's the down-side of it being a provincial responsibility instead of federal.

Some hospitals provide inanities like "Healing Touch" via their chaplaincy/spiritualism programs. That's where it belongs!

Change.org is running a petition in Canada to lower the costs of medications. Here's part of the letter:

Canada is the only country in the world that prides itself on universal healthcare, yet contradictorily does not have universal medication access. Canada has 19 publicly funded drug plans and over 1000 private insurance programs: a fragmented, non-equitable patchwork that leaves many uncovered. We spend 30% more on drugs than nations with Universal Pharmacare programs!

Canadians spend more than $700 US per capita for prescription, non-prescription, and personal health supplies, whereas the average per capita expenditure for OECD countries is $500.

In a recent Angus Reid Institute national survey nearly 1 in 4 Canadians did not take a prescribed medicine because she/he could not afford it. Food and shelter costs undermine medication costs when it comes to day-to-day survival. Inadequately treated chronic disease inevitably decompensates. Hospital admission for acute disease management then culminates in hefty inpatient costs.
Our generic drug prices are dependent on patented drug prices, established as the median of seven comparator OECD nations. This list includes the four places in the globe where drugs are most expensive.

Prices for the same medicines vary depending on province or territory of residence. In order to make drug prices more appealing to provincial and territorial governments, pharmaceutical companies artificially inflate prices to present the government with a “discount price,” whilst channeling the cost burden to third party insurers (10% higher costs compared to government costs) and most significantly to out of pocket purchasers, many of whom are the working poor.

Take the price of the common cholesterol medication, atorvastatin, which is cheapest in Ontario and costs 31 cents. Compare this to that same pill in New Zealand, which costs 2.6 cents!

@ORD #25:

Thanks for bringing that to light. I wonder if anyone today would dare to re-enact the event in a movie.

If you think that story is worth retelling, look up the Businessmen's Plot of 1934.
Then think about the lengths they were ready to go to, and what is happening in the US today, and how easily it was brought to be.

Heh, Smedley Butler managed to monkey wrench that plan up quite effectively.

@ORD,Wzrd1: The question is, do we have a Smedley Butler today?

Much of Silicon Valley (though not all: Peter Thiel and Uber, to name two prominent examples) is opposed to what Trump is doing. I've seen a secondhand report that Sergei Brin, who came to this country as a Russian Jewish refugee, was among the protestors at SFO last night.

But lots of other money people (e.g., the Koch brothers) are on board, so far, with President Scheisskopf (or, as some others have called him, Dolt 45). And it's an open question which way the US military will go if the feces intersects the rotating blade.

The feces has already hit the rotating blade. CBP is in open contempt of multiple federal courts by refusing access to attorneys to those unlawfully detained in our airports. Contempt filings have been made.
So, we'll end up with federal marshals enforcing the federal court orders, placing the DOJ and DHS into open conflict.

As for the military, their loyalty is to their Constitution and if a Commander in Chief disobeys that Constitution or issues unlawful orders, they'll ignore the unlawful orders.

re 'Dolt 45' ( hah!)

Supposedly he will fix up ** veterans' care by adding private practitioners.
Does anyone imagine that the line between woo and reality will not be clearly drawn in this instance as one does not exist at all in the Dolt himself?

re faeces / rotating blade

Right. It's happening now at various airports.

** more likely, f@ck up

We can settle this with a tennis match (kidding).

But seriously, what is ORAC's deportment like when he is forced to converse with woo peddlers? Does it ever come to blows?

Just curious. I know the language can get kind of heated ,online at least.

Can you post your most negative e-mail?

There is a typo in your first paragraph by the way: "Sometimes, I even get e=mails that tell me that my blogging was the reason someone turned away from the dark side of antivaccine quackery or other pseudoscience."

Now, perhaps "antivaccine" has become a proper word in the blogosphere, but "e=mail" is an obvious typo.

Not a big deal.

Integrative medicine? Let's see what we get when integrating real medicine (☤) with woo (☯) cubed:

∫☯³d☤ = ☹ + C

You see, you get a sad face plus a constant.

This is not good. You don't need to be a Ramanujan or Euler to know this.

As for the military, their loyalty is to their Constitution and if a Commander in Chief disobeys that Constitution or issues unlawful orders, they’ll ignore the unlawful orders.

Yes, I know that is how it is supposed to work in theory. Also in theory, the US military is not supposed to involve itself in domestic affairs. I see a much-higher-than-I-would-like probability that these two principles will come into conflict sometime in the next four years. What happens then? I'd prefer not to learn the answer to that question, but as the great philosopher Mick Jagger noted, "You can't always get what you want."

Also in theory, the US military is not supposed to involve itself in domestic affairs.

Not a theory at all, military officers careers have spectacularly ended for violating the Posse Comitatus Act.
https://en.wikipedia.org/wiki/Posse_Comitatus_Act
Note the exclusions and limitations.

I agree with the wizard -- but a lot of things that were unthinkable two and a half months ago are no longer unthinkable.

I'll say! First, acting director DOJ is fired for not defending an unconstitutional executive order, now the director of ICE was fired and replaced (even money, the back story will be that the acting director was going to comply with the five different federal court orders to let detainees have access to attorneys, which were ignored all weekend.
Next up, DOJ will refuse to send federal marshals to enforce the orders of the court, perfecting a constitutional crisis via violation of the checks and balances between the judicial branch and executive branch, leaving even Congress' powers undermined.

In the hospital for combat injures located in San Antonio, TX they have booths advocating mindfulness. Again diluting the care received by active duty military. Quackery is so much more cost effective and the army runs on the lowest bidder.

Okay, I know I am really late to the party here, but I wanted to add my experience with quackery in military medicine/the VA. As a medical retiree, I am eligible for both military insurance (Tricare) and VA care. As treatment for chronic migraine, 5 separate neurologists and pain management specialists have recommended Botox, which is now FDA approved for this indication. Neither Tricare nor the VA is willing to pay for it, however, despite it being much cheaper than ER visits, which they would pay for even if I went weekly (despite the fact that ER treatment for migraines is totally inappropriate in most cases). The VA, however, would be happy to let me try accupuncture as part of a pilot program. Tricare is less generous; they have also suggested acupuncture, but at my expense! Sadly, even some civilian specialists have offered accupuncture as a valid treatment, as well. Sigh.

Triptans aren't effective for your headaches?
I've had both Zomig and Imitrex for migraines and they were exceptionally effective on mine.
My wife didn't have quite as good an experience with that class, but ergotimine was effective.

I am surprised at the botox bit though, as it's not exactly an expensive treatment. Did they state the reason for declining that specific treatment, such as calling it experimental or claiming a lack of efficacy?

@Wzrd1,
Unfortunately, triptans work for me moderately well, but using them as frequently as I have migraines would lead to rebound headaches (they are often worse than the original!) and deleterious cardiovascular effects.

VA's denial of Botox is done with "we don't do that here" and ignoring further inquiries.

Hilariously, while I was still in the Army, the neurologist at Walter Reed told me with a straight face that they had found Botox to be ineffective for treating chronic migraine. This while outside the exam room was a poster (presented at a recent conference by colleagues in her own department) showing moderate efficacy for that same indication. When I pointed this out, I got the usual "shut up, soldier. I'm a doctor and an officer and arguing with me is insubordinate," spiel. When I countered that, before enlisting, I finished two years of PhD research (as a National Science Foundation Research Fellowship awarded) in biophysics/neuroscience, she sneered that I must be lying since nobody that smart would be dumb enough to join the Army, much less as a lowly enlisted person...Nothing like the sweet scent of prejudice in the morning...
Tricare tries a more subtle approach to denial. I actually managed to get the administration of the Botox covered fairly easily, after only four attempts. Getting the actual drug proved more difficult. The pharmacy benefit argues that they are not responsible for paying since it is administered at the doctor's office and is therefore not within the scope of their contract (even though other drugs, like DepoProvera, administered at the doctor's office, are covered). The medical benefit contractor says they are not responsible because Botox is a drug and thus outside their coverage area, as well.
Even more cleverly, these sorts of denials are not appealable, because they are not actually denials but "administrative rulings on contractual obligations".... Attempts to get both the medical and pharmacy benefit contractors on a conference call and let them duke it out between themselves are met with utter failure.
After two years of this idiotic merry-go-round, I have not given up, but I hold little hope of actual success :-(.

Bet you didn't expect to open such a can of worms with your question, no? ;-)

Heh, I actually did expect a can of worms, actually a case of cans of worms.
We are talking about tricare and the VA, after all.

As for Army doctors, I tend to talk shop with them and it gets instantly obvious that I have a clue about what I'm talking about. I'm also pretty good at being insubordinate while still staying out of trouble.
You don't put in near 28 years without learning how to hand it right back to an officer, respectfully, of course. ;)
Even at Wally Reed.

I'm fortunate in that my old migraines were rare, typically every couple of years apart and now, they're a painless variety.
https://en.wikipedia.org/wiki/Scintillating_scotoma
Painless and passes in about a half hour, while I still am sensing the aura.

I need to take lessons from you, I guess, Wzrd1. There does seem to be a gender and age component to willingness to listen. I was only 27 when I got my PEB/MEB decision, and every time my husband drove me to a Walter Reed or VA appointment, everyone assumes he is the veteran/servicemember. This is somewhat hilarious, because my nerdy, engineer husband would not be military material in a thousand years!
Talking shop as a 27-year-old female vet tends to get skeptical looks and an admonition to "stop thinking Google is a good resource for medical info". Telling the doc I use PubMed and subscribe to Science and Nature gets a "yeah, right!"
One memorable night, when Relpax had just come in the market, and the brigade surgeon had special ordered it for me due to issues with other triptans, my platoon sergeant hauled me down to the ER because I was badly dehydrated from all the vomiting. The ER doc tried to give me DHE, only two hours after my last dose of Relpax.
All I wanted/expected was some Zofran and fluids, not a dangerous and potentially lethal drug interaction, but the doc wouldn't believe me that Relpax was a triptan, saying he'd never heard of it,
It ended up in me physically covering the IV ports while a tech, a nurse, and the doc hollered at me. Eventually I managed to escape AMA, only to get raked over the coals by my company commander the next morning!
The CO insisted that I should stop trying to second guess doctors, after all I was only a staff sergeant, and next time I better just shut up and do what I was told. When I tried to explain about my educational background, he said I must be lying due to my young age. Trying to explain to him that I graduated college at 18 and thus had 2 years of PhD work under my belt when I enlisted at 20 was futile.
He was a former enlisted infantry soldier who had gone OCS a few years back with one of those online bachelor's degrees where you get three years of credit for "life experience". Commanding a company full of "MI weenies", more than 60% of whom had bachelor's degrees and some 15% of whom had at least some graduate education was deeply threatening to his ego.
I never really mastered the technique of getting officers to listen to me if I was dismissed as ignorant because of my age. I think that perhaps if I had been able to serve until retirement age, it might have been easier to not be summarily dismissed.

Bringing woo to disaster areas

oracknows — Tue, 26 Jan 2010 08:00:00 +0000

Bringing woo to disaster areas

Almost two years ago, I discovered something that disturbed me greatly. Basically, I learned the story of an Air Force officer named Col. Richard Niemtzow, MD, PhD. Col. Niemtzow is a radiation oncologist who has over the last decade fallen deeply into woo. Specifically, he has become known for a technique that he has dubbed "battlefield acupuncture," a technique that he has promoted energetically (word choice intentional) and ceaselessly, to the point where, sadly, the military is starting to take it seriously even though the evidence Col Niemtzow has presented in favor of the technique is at best the thinnest of gruel, with no controls and no blinding. He's even managed to convince the military to deploy acupuncturists to Iraq to take care of wounded soldiers. No doubt soon he'll manage to get acupuncturists deployed to Afghanistan too, since that's where the fighting increasingly is. As I pointed out, that's just what our wounded heros need: Quackery instead of medicine. I was thoroughly disgusted.

War, disaster, violence, if there's one thing I've noticed about quacks, it's that they labor under the delusion that they are real health care providers and that what they do will actually help people in dire straights. That's why they think their woo can contribute whenever disaster strikes.

And few disasters can rival the scale of the earthquake in Haiti two weeks ago.

True to form, the woo-meisters have invaded. We have Homepaths Without Borders planning a trip to Haiti in order to bring quackery to the injured, homeless, and starving masses. Just as bad, if not worse, and as if the Haitian people didn't have it bad enough already, they also have Scientologists invading their devastated island to bring Xenu to cure them of their injury and disease in the wake of the earthquake that killed at least 150,000 people:

Amid the mass of aid agencies piling in to help Haiti quake victims is a batch of Church of Scientology "volunteer ministers", claiming to use the power of touch to reconnect nervous systems.

Clad in yellow T-shirts emblazoned with the logo of the controversial US-based group, smiling volunteers fan out among the injured lying under makeshift shelters in the courtyard of Port-au-Prince's General Hospital.

A wealthy private donor provided his airplane to fly in 80 volunteers from Los Angeles, along with 50 Haitian-American-doctors, in a gesture worth 400,000 dollars, said a Parisian volunteer who gave her name as Sylvie.

"We're trained as volunteer ministers, we use a process called 'assist' to follow the nervous system to reconnect the main points, to bring back communication," she said.

"When you get a sudden shock to a part of your body the energy gets stuck, so we re-establish communication within the body by touching people through their clothes, and asking people to feel the touch."

What the heck is that supposed to mean, "reestablishing communication," "reconnecting the nervous system"? It's faith healing, and faith healing doesn't do much good for broken bones, crushed spleens, fractured skulls, and severed spinal cords. Actually, it doesn't do much good for anything that can't be improved with a placebo. Yet, this is what Scientologists are bringing to the suffering masses in Haiti. As one of the real doctors snorted, "I didn't know touching could heal gangrene."

Speaking of healing gangrene, surgeons are desperately needed in Haiti, surgeons who can debride dead tissue and amputate gangrenous limbs. They're getting them, too, but unfortunately, they're also getting surgeons who carry a bit of baggage with them in the form of woo. True to form, it would appear that acupuncturists are planning on joining the homeopaths. I know this because Lisa Marcucci, MD, trauma surgeon and medical acupuncturist, wrote an astonishingly brain dead defense of Col. Niemtzow's "battlefield acupuncture." Worse, it was published on a blog that is normally a reliable source of medical information, Inside Surgery. In an article entitled Battlefield Acupuncture (Niemtzow Technique) and No Needle Battlefield Acupressure (Marcucci Technique) for Pain Control in Acute Traumatic Injury in Haiti:

One of the more distressing items being reported out of the developing medical catastrophe in Haiti is the lack of even rudimentary anesthesia and analagesia for the treatment of amputations and severe acute traumatic injuries.

One possible strategy for treating patients in pain that is rapidly effective, and has little mortality or serious morbidity risk is the use of battlefield acupuncture, a technique pioneered by Air Force Col Richard Niemtzow, MD PhD in 2001.

Because Dr. Niemtzow's battlefield acupuncture technique is most effective when using specialized small, gold-plated needles that are not always readily available, I have adapted his work to a technique I call battlefield acupressure.

It is truly horrific the level of medical catastrophe going on in Haiti right now. Thousands of people have died; thousands more are injured, many seriously. The medical infrastructure is utterly inadequate to the needs of the people right now, and, despite the outpouring of good will and aid from the rest of the world, it will still be quite a while before international aid reaches levels that begin to address the suffering of the Haitian people. Many will die of their injuries and disease before things get better; many will remain homeless for a long time; some will even die of violence, given that desperate people will do desperate things. The scale of the devastation and human suffering is beyond the ken most people. It's only human nature to want to help, and Dr. Marcucci wants to help.

But first she wants to whine about how badly advocates of science-based medicine treat acupuncture:

Despite the fact that acupuncture has been in use for the treatment of pain for 3000 years, its' use today still remains somewhat controversial and has many reputable critics in the medical establishment.

These authorities point out the lack of compelling, unimpeachable level 1 evidence to support its' use and cite existing studies concluding the effect affect of acupuncture is no better than placebo.

Well, yes. That's true. I've documented it time and time again right here on this very blog. Just search for "acupuncture" in the search box in the left sidebar if you don't believe me. Basically, acupuncture doesn't work better than a placebo. Indeed, sham acupuncture works just as well as "real" acupuncture, and neither of them are more than elaborate placebos. Contrary to claims of any specific actions due to acupuncture or any clear mechanism, we know that it doesn't matter where the needles are placed, and it doesn't even matter if the needles penetrate the skin. Toothpicks produce the same result. I do like how Dr. Marcucci whines about how there is no "unimpeachable" level 1 evidence. Actually, it's a lot more than that; the totality of the evidence supports the conclusion that acupuncture is no more than a placebo. Small, pilot projects produce seemingly positive results, but the bigger and better designed the study, the less the effect, and apparent effects due to acupuncture disappear completely in the largest, best-designed studies using the best acupuncture placebos.

Not that this stops Dr. Marcucci from making a classic argumentum ad populum and an even more classic appeal to authority, logical fallacies both:

What remains inconvertible, however, is that acupuncture is widely sought by the public and its' use has now been adopted by major academic medical centers such as Harvard University, Stanford University, UCLA Medical Center and the University of Maryland where it is used in the oncology and trauma units.

It is also widely used in the Veterans Administration and throughout the United States Military, where it is now being taught to special operations forces, medics, nurses, and physicians alike for use literally on the battlefield as well as in fixed medical facilities.

Therein lies the danger of the infiltration of woo into academia and the military, promoted by men like Col. Niemtzow. "Authorities" that should know better are coopted by quackery. How are lay people supposed to know that these authorities don't know what they're talking about when it comes to various forms of pseudoscience? After all, medical authorities are using it! There must be something to it, right?

Wrong. As we have seen, academia has been coopted. Quackademic medicine has infiltrated medical schools and hospitals.

Then, Dr. Marcucci launches into a totally disingenuous rationale for why to her it's appropriate to bring acupuncture to suffering Haitians:

And, in judging whether this would be an acceptable treatment modality for Haitian patients, what is also irrefutable is the complete absence in many situations of any modern level 1 evidenced care currently being practiced in Haiti.

As an example, some practitioners are being forced to amputate limbs on awake patients placed on bare wood tables under dirty bedsheets (i.e., Civil War era medicine).

In this situation, perhaps the lack of a wide body of level 1 evidence for acupuncture use and the ongoing academic dispute about its efficacy is a nicety that the medical community and Haiti can not now afford.

In other words, to boil it down to surgeonspeak - it may work, likely won't hurt, but you gotta try something because we are cutting off people's legs without narcotics or anesthesia.

In other words, because the destruction of Haiti's medical infrastructure has led doctors to be forced to operate under primitive conditions without adequate medicine or surgical supplies (i.e., forcing them to use techniques with less than "level 1 evidence"), then we should abandon all scientific pretense! Send in the woo!

Yes, it is horrible that amputations are being done without anesthesia. People are suffering. However, if you can send acupuncturists in, why can't you send real doctors in with real anesthetics, or at least with real morphine? Morphine's cheap and abundant. It may not by itself serve as adequate anesthesia for an amputation, but it can do a hell of a lot more than placebo medicine like acupuncture. Heck, just calmly holding a patient's hand can do at least as much as acupuncture, no woo needed.

Sadly, though, Dr. Marcucci can do nothing but lay down the woo:

All pain signals in the body reflex through one or both of the earlobes on its way to the brain.

In many patients, there are 5 main points that can be stimulated through needles or pressure on each earlobe that will partly or totally block this reflex, thus diminishing or eliminating patients awareness/experience of pain.

This is nothing but the purest nonsense. There is no physiologic or neurologic basis to make such a claim. That a surgeon--a trauma surgeon, no less!--would make such a claim and actually believe it is profoundly disturbing. It turns out that Dr. Marcucci is actually the person who founded Inside Surgery. Clearly, I haven't been paying enough attention to this blog; so I did some searches. I didn't find anything about acupuncture other than this post or links to this post. Apparently disaster finally got Dr. Marcucci to let her woo flag fly on her blog. Before that, she had not mentioned that she is a medical acupuncturist.

Remember how I used to joke (well, not exactly joke) that I wanted to put a paper bag over my head like the unknown comic and then later a Doctor Doom mask over our "favorite" creationist neurosurgeon Dr. Michael Egnor? I think it may be time to get the metal mask out again. I've found a surgeon who embarrasses the profession and, through the profession of surgery, me just as much Dr. Egnor does.

The Haitian people deserve better. Much better.

oracknows Tue, 01/26/2010 - 03:00

Tags

complementary and alternative medicine

complementary and alternative medicine

medicine

Politics

All pain signals in the body reflex through one or both of the earlobes on its way to the brain.

WTF even I know enough anatomy to know this is ridiculous. This person is a doctor - this is like an engineer pimping a perpetual motion machine.

Wouldn't an injection of saline be a better placebo if morphine is not available. Of course as Orac points out, if you can send acupuncturists you can send morphine.

How about ketamine for the "battlefield anesthesia"? When my better half worked in anesthesiology she used to tell me ketamine was very popular in settings (like battlefields and distant developing world settings) where they didn't have anesthesiologists and fancy monitoring. The main point was that it didn't depress respiration and blood pressure the way the opiates did. Or maybe ketamine for operations
and then opiates for post-op pain relief.

I've had my own say about the homeopaths and their rather self-centred view that homeopathy is what Haiti needs on my blog. See: Money is better disaster aid than homeopathy

Like you say, though, it is especially depressing to see real doctors joining the "Woo for Disasters" gang.

So, then, if you amputated both earlobes, you'd never again experience pain of any kind?

@ Dr Aust:
Ketamine; precisely so.
http://www.irishtimes.com/newspaper/health/2010/0126/1224263113573.html

More comment on the Scientologists' efforts: Don't panic Haiti, the Scientologists are coming!

Sigh. Inside Surgery needs to hire an editor, in addition to considering the scientific validity of its content. "Its' " doesn't make any sense. She should have used "its" throughout. Think "hers' ' or "ours' " or whatever.

Sorry, pedantic...but argh.

I think the "wealthy private donor" is John Travolta. I heard a news story this morning saying that he had flown his 707 from Florida to Haiti, bringing 4 tons of medical supplies and a number of people; I would imagine that those 80 people mentioned are the one in question.

Acupuncture is interesting. You'd think it might work due to the same mechanism that, say, a bruise might hurt less if you rub it, but nope! I guess that's why toothpicks are just as effective, though. :P

All pain signals in the body reflex through one or both of the earlobes on its way to the brain.

What the hell?

All pain signals in the body reflex through one or both of the earlobes on its way to the brain.

Does this mean if you cut off your earlobes, you'll never feel pain again??

I'd rather see Travolta out there than Cruise. Travolta still has a good head on his shoulders (more or less), but Cruise has lost the plot.

"I think the "wealthy private donor" is John Travolta. I heard a news story this morning saying that he had flown his 707 from Florida to Haiti, bringing 4 tons of medical supplies and a number of people; I would imagine that those 80 people mentioned are the one in question."

Unfortuntely for any good this might have done, those 80 people are scientology volunteer ministers, and they left 70 doctors and nurses behind (Non-Scilons) who asked to go on the flight.

@Jeff Read #11

What difference does it make which movie star is bringing in people to do the woo?

Orac, This is the post I have been waiting for. It's fine to expose the Mike Adams' of the world, but the serious problem of medical professionals adopting woo is scarier to me. I can choose not to involve myself with a woo practitioner, but now I have to screen my MD for woo tendencies! My pregnant internist informed me that she was going to "look into it more" before she would get the H1N1 shot because "they didn't have any without thimerisol and what if.....?" Arghhhhh, she is very sweet, but I nearly went ballistic as I bit my tongue and gently reminded her that she is a trained scientist who knows better than to listen to such nonsense. She blushed and countered that she just didn't want anything at all to harm her baby. I give up!

I also had a number of female gyn's try to get me try all sorts of herbal crap for years before I (finally) found a woo-free MALE gyn to do what was really in order--a hysterectomy!

I was referred to a neurologist (for some routine testing to rule something out) who "prescribed" fish oil supplements. I asked for some evidence and was sent a clipping from a local newspaper column written by an "herbal healer".

Lest you think I live in some hippy-dippy enclave (and I have), this all happened in the midwest at mainstream clinics.

I think the underlying tolerance of religion that is so integral to our national makeup makes it difficult to question the practice of woo without seeming to be "intolerant" or "narrow minded". It is definitely up to doctors to police their own numbers and purge the woo from the profession. I realize that the words "police" and "purge" may conjure negative images, but I use them to urge strong action from within. The public simply does not have the basic skills to sort it all out--they see MD and figure it must be "true".

I'd rather see Travolta out there than Cruise. Travolta still has a good head on his shoulders (more or less), but Cruise has lost the plot.

really?

What Anthro said. Gogogo Orac!

Homeopaths without borders? Lets be honest, they're sociopaths. I don't know how anyone with a conscience could go to Haiti and tell them that all they need to do is drink some water and that will fix their problems. And convincing large groups of people that water will cure them is a clear example of antisocial behavior. Truthfuly, call a spade a spad: 'Sociopaths Without Boarders'

Homeopaths without borders?

Well - they do not recognize the border between fantasy and reality.

Even after all the scandal of the New York Rescue Workers Detoxification Project post 9/11, and the same routine after the London bombings, for some reason Scientologists continue to push their worthless and dangerous Purification Rundown (TM). They put together a Utah Meth Cops program http://www.youtube.com/watch?v=gRtx6FppyN0 that received public funding. It is also the method used for their drug rehab company Narconon.

And now Travolta plans to start up The Ocala Detoxification Project. Fundraising will begin at the Ocala premiere of his new film. Why this method is even legal is beyond me.

"Detoxification treatments include daily doses of immediate-release niacin, aerobic exercise, intermittent sauna, cold-pressed oils to prevent toxins from being re-absorbed by the intestines, and vitamin and mineral supplements, according to the International Academy of Detoxification Specialists."
http://www.ocala.com/article/20100123/ARTICLES/1231016/1001/NEWS01?p=1&…

Eek. He plans to inflict this on yet more rescue workers!

Here is a question- If the real medical aid is not available, is it harmful to provide placebo help to people in pain? I am fully against this woo when it prevents people from seeking real help, or when the woopeddlers are charging for nothing. But it is well documented that placebos can help some minor healing, e.g. when soldiers get shot and know they get to go home, they heal faster and need less painkiller than civilians who have similar injuries. The damage here I can see would be to give legitimacy to the woo. Just wondering.

More comment on the Scientologists' efforts: Don't panic Haiti, the Scientologists are coming!,/blockquote>

Like Haiti doesn't have enough problems...

I'm sure the earthquake was caused by island thetans.

What hogwash. Combat Woooo.
If I was able to train and deploy "combat acupuncturists" to the combat area ( aka the "sandbox") I should be able to, oh say just for example, provide some extra training in actual proven therapy to advanced practice combat medics/Independent Duty Corpsmen and or the deployed nurses of the US Army and Air Force and Navy. Actual proven therapy would be weird things like digital nerve block/regional anesthesia or systemic analgesics... and or some general relaxation and distraction techniques.... you might know them as "nursing interventions" or psychological counseling techniques. Wacky huh?

I recall having read about this a while ago.. seemed almost like a prank story it was so weird. They were actually researching shortened acupuncture needles that could be inserted and enable continued wear of helmets, and if I recall accurately, continue to "go out and patrol" sort of thing. and no doubt they were going to tint the needles green or tan, and enclose in some sort of a camo-colored nylon case.

The troops need REAL CARE, REAL MEDICINE, REAL PAIN RELIEF. I might assign some sort of value and benefit from a "combat acupuncturist" having spent time focusing on the needs, comfort, and pain issues of a patient in the military medicine system. If the time and money is there for the training... TRAIN with actual medicine/nursing. If the money is there to deploy more health professionals... SEND REAL ACTUAL professionals that can add enhanced pain management techniques to their 'toolkit' and arrive with many skills.

just my thoughts. only 26 years experience in military medicine and nursing.

"The damage here I can see would be to give legitimacy to the woo."

That's what the acunpuncturists and homeopaths most desperately want.

The problem is that they're taking up space and resources needed for critical, life-saving medical care. What happens when parents with a sick or injured child go to the first practitioner they happen to see, and it's a homeopath?

Societies with readily available, quality medical care and abundant resources can withstand having quacks operate. Haiti can't.

As one of the real doctors snorted, "I didn't know touching could heal gangrene."

It can't, but I find it very effective against erectile disfunction.

From yesterday:

"Cedar Rapidsâ Peter Teahen â disaster specialist, funeral director and recent candidate for the U.S. Congress â is flying into disaster-hit Haiti this evening with actor John Travolta and a medical contingent in Travoltaâs jet.
...
Teahen, who is not a Scientologist, said the church has come to play a bigger and bigger role in disaster relief both internationally and in the United States."

http://www.kcrg.com/news/local/82636077.html

Scientology: can't make this stuff up.

I can't find the article on SBM where this was discussed, but isn't the claim that "acupuncture has been in use for the treatment of pain for 3000 years" also about as full of it as it gets? I was under the impression that the documented history of accupuncture was only a couple of hundred years at most. But hey, why let pesky facts get in the way of a good Ancient Whizdom™ narrative, huh?

Jesse P. asks:

"Here is a question- If the real medical aid is not available, is it harmful to provide placebo help to people in pain?"

If it were truly a choice betweeen nothing and placebo, then it would be better to give a placebo.

However, the real question is:

"Given a finite amount of aircraft space and a finite number of landings at Port-au-Prince, is it better to send placebos (e.g. homeopaths, Scientologists, acupuncturists) or real medicine (e.g. surgeons, anesthesiologists, antibiotics, analgesics, etc.)?"

In this case, ethics demands that we send real help to people in need, not placebos.

Hasn't Haiti suffered enough?

Prometheus

So I don't normally comment, but I'm going to go out on a limb and speak for the homeopaths. If they could in fact dilute all the stuff in the water out to the point of non-exisitence, wouldn't that make them unusually useful for a change? I mean, if they were to provide clean drinking water, that might actually save lives. For once, I think they might unwittingly be on to something.

@Robin

Only if they give liter+ size megadoses, I suppose, with solutions in an aqueous form (i.e., no pills, no alcohol-based concoctions).

So how about the following arguments

Despite the fact that stone hand axes has been in use as tools for 500000 years, heir use today still remains somewhat controversial and has many reputable critics in the engineering establishment.

Despite the fact that clay tablets has been in use as writing implements for 5000 years, their use today still remains somewhat controversial and has many reputable critics in the information technology establishment.

I never understand this type of argument.

I suppose that Homeopaths without Borders will at least bring much-needed water to people in need...

Didn't the Pentagon learn its lesson from its Iraq and Afghanistan coalition partner's experience with bogus bomb detectors?

Its absolutely disgusting in Haiti. They have one runway which is being run from a converted trailer. Its gone from 5 flights a day to 24 hour service. Not enough space on the ground to get enough supplies and personel in, there's a nice waiting list to land.

And somehow revolta got his private jet in with 80 hacks that will undermine the actual work being done, as well as delaying actual help. The scientologists are even complaining about how they're being scorned, thinking it was because they wear yellow t-shirts (I'm glad they do, I'm sure most people in Haiti are happy its easy to spot a scientologist and go the other way... if they're able to move.)

We could so easily have had farmers in Afghanistan growing poppies for more morphine, just to help handle emergencies like this (we probably already have a large enough emergency supply, i don't know.)

@Prometheus:
"If it were truly a choice betweeen nothing and placebo, then it would be better to give a placebo."

I seldom disagree with you. However, if you receive nothing because nothing is available, you'll realize that and try to do what you can to help yourself. This is better than the false hope of a placebo (or, something touted as having a benefit when it has none).

"Hasn't Haiti suffered enough?"

In light of its history since the first revolution in 1803, probably not (not that things were better before 1803, unless you were a planter). What is truly amazing is how different a place the Dominican Republic is.

Homeopaths Without Borders should work according to the principles of homeopathy. Dilute the homeopaths with more and more doctors until no homeopaths are going. People will get well. Don't forget to strike the homeopaths - very important!

An untrained lay person would be better than a homeopath. They would spend their time trying to help out in some manner that actually did something. They wouldn't claim you were miraculously healed. They wouldn't sit around doing nothing but lying to patients. Maybe they'd just end up doing manual labor. It'd be better than nothing. Homeopaths and scientologists aren't worth the jet fuel. Leave the seat empty if you can't fill it with somebody useful.

@t_p_hamilton

Don't forget to strike the homeopaths - very important!

No, no. It's shake, not strike. Succuss, not concuss.

I realize that the lack of infrastructure and government is part of the problem when it comes to disasters, but who gets to decide who comes? I mean, do they have to accept everyone who shows up?

'All pain signals in the body reflex through one or both of the earlobes on its way to the brain.'

On the planet of the Ferengi maybe.

I have no words with which to express my contempt for these miserable lousy no-good sons of dogs who would send people to point their gods-damned fingers at people and smile instead of offering real help. they should be conscripted into doing actual useful work, and made to pay their own way home.
Don't let them have a blasted vacation, pointing their fingers at people and chanting happy verse, put them to work!
Let them see the devastation first hand, and then ask them if they would have been willing to give up their seat on the plane to an actual doctor or nurse. Unfortunately, most of them will say "but we *are* helping! we really are! "
As for the homeopaths... perhaps they too could help by clearing away rubble and debris, and by using their happy homeopathic skill to bury the dead. I'm sure there's more than enough of that latter chore to keep them all busy.

PS: My heartfelt apologies to dog lovers everywhere for comparing those Scientology cretins to dogs.
It's an insult to the canine species.
I would compare them to slime, but slime actually serves a useful purpose.

Bless Agence France-Presse for staying on top of this.

Travolta flies aid, Scientology to Haiti
http://www.google.com/hostednews/afp/article/ALeqM5jeF5ussei3k0K7yvLch5…

"A number of young Haitian men, desperate for work, and food, were being taught the technique by volunteers and were encouraged to make "touching" rounds themselves.

Carol Delva, 29, suffered a crushed knee when her house collapsed on her, and lay inert on damp sheets in the courtyard while LA-based Scientologist Dave McGregor touched her feet, legs and torso, thanking her with a "merci" after each poke."

( http://en.wikipedia.org/wiki/Touch_assist )

I guess I have to thank Travolta for bringing extra publicity and scorn to junk science. Wouldn't it be great if we could have Dawkins do something like "The Enemies of Reason" on US TV? PBS used to be about Carl Sagan, not Wayne Dyer. We've gotta fix that. This could be a way for them to become relevant again. (Yeah, I think about this a lot. I also think we need more Brian Cox in People Magazine.)
http://video.google.com/videoplay?docid=-4720837385783230047&ei=trxfS-2…

Though I don't care for Scientology but at least they are willing to do something, more than most who post on this forum including myself :( I used to be fundamentalist leaning but now consider myself a rational deist. One of the wise sayings I heard was "what a fundamentalist cannot understand he deems as evil", I think I am hearing this from the fundamentalists of Skepticism. At least the people care enough to help someone (albeit in a method that the Skeptics do not understand) and are not scoffing at those who hold differing viewpoints.

Multiple info dump, I know.... What else can I do.

Apparently Scientology supporter Peter Teahen, (post #24), is a national media spokesperson for the American Red Cross. Teahen has been interviewed on âLarry King Live,â âGood Morning America,â âOprah,â the Weather Channel, Fox News, The BBC and Al Jazeera Broadcasting Company. He has his own website. Teahen met Travolta during Hurricane Katrina.

Patrick @ 42 :
What, pray tell, are the scientologists actually doing ?
go back and read through. They are not in fact doing anything useful, not even donating money. What they are doing is sending people out for a Public Relations gimmick to practice "Energy Medicine." Do you really believe such works ?
Do you ? If it doesn't work, why then are they doing it, and how is this helping the people whose lives have been blasted by this disaster ? They aren't delivering food, water, medicine, shelter or other supplies. They are simply pointing their fingers at people or touching them and then expecting them to get better. Patrick, doing the wrong thing is worse than doing nothing. In this case, they are doing harm by omission, and deliberately doing so.
Donating money would have at least eventually helped the people of Haiti to some small extent.

patrick # 42:
The "something" they are doing is worse than nothing. If they were doing nothing, a plane full of doctors, surgeons, and medical supplies, or even just volunteers to help clear away rubble / do whatever else is needed could have landed. Instead, you have a bunch of people who are going to actually interfere with medicinal aid (through methods such as telling people they don't need medicine, teaching other volunteers how to properly "poke" patients instead of useful skills like sterilizing water and bandages, etc.)

Homeopaths Without Borders should work according to the principles of homeopathy. Dilute the homeopaths with more and more doctors until no homeopaths are going.

What about throwing the homeopaths in the middle of the ocean and letting them dilute from there?

(Yes, the behaviour of these people brings out my misanthropic side... why do you ask?)

John Harrold: I've no problems with homeopaths handing out water that "remembers" all sorts of things as a cure for whatever ails folk. I just hope they're boiling the water before they give it to people. It would be horrible if the water "remembered" things like the bacteria which cause cholera, or typhoid, or any number of other water-borne diseases. Particularly if the water "remembered" them in sufficient quantity to cause an epidemic. I mean, call me picky, but I figure disease epidemics are right up there on the (long) list of things the people of Haiti don't need at this point.

At least the people care enough to help someone (albeit in a method that the Skeptics do not understand) and are not scoffing at those who hold differing viewpoints.

define help in the way that Scientologists are helping

The video footage is kind of heartbreaking. I think John knows he's not doing the right thing.
http://thelede.blogs.nytimes.com/2010/01/26/travolta-flies-more-sciento…

I know Scientology gossip isn't the purview of this blog, but as some background you should know that the cult is getting into deeper and deeper doo-doo these days.

http://tampabay.com/news/scientology/article1067720.ece

(Futher - Nick Xenophon and the Australian senate, Californian labor violation and human trafficking class-action lawsuit, last autumn's fraud conviction in France, wrongful death suit in Italy, federal charges in Belgium, etc etc)

Meg Thornton @47: homeopaths always make a big point of insisting they use "double distilled water" (this, in their Parallel Universe, is supposed to "wipe" the memory of all the other s**t the water has had dissolved in it).

Of course, if you had ddH2O in quantities in a disaster area the most therapeutic thing you could do with it would be to use it to prepare oral electrolyte solutions for people with diarrhoeal diseases, and/or use it in medical procedures if you don't have sterile water to hand, or just give it to give it to people to drink (since it should be microbiologically clean). No need to shake it homeopathologically first for that last one.

Anyway, there would be A LOT more useful uses for ddH2O than making homeopathic remedies. And given this, I am 99% certain the "homeopathic first aiders" WON'T be giving out aqueous remedies. They will, I confidently predict, be dishing out placebo sugar pills. Which contain no water - only the "memory" of it, ho ho.

As to Patrick @42's comment - first, as dlc@44 and darius@43 noted, the Xenoids are actually getting in the way of the real relief effort.

Second, they could instead have done some good by raising funds from their supporter network to give to the main relief agencies. And as I said in my blogpost on "Money is better disaster aid than homeopathy", the very best thing you can do, as a member of the public, is to send money. It may feel like nothing, but it isn't. It will be used to provide the disaster relief. Read this excellent post from a British Red Cross worker describing why the money is what they need the most.

If they are amputating without anesthesia, perhaps they are at least using broad tourniquets to cause mechanical anesthesia? Please?

Thanks, Jen, for all of your posts--I think we are on the same page.

As to the scientologists--are they going to "point" to the amputation stumps and cause new limbs to grow? Why not, if the method is valid? At least this is a phenomenon that can happen in the natural world, unlike their touchy-healy nonsense.

Patrick: You need to read up on skepticism. Arguing reason against magic is not the equivalent of disagreeing over a "viewpoint".

k8 @ 37 - I believe it's different in every disaster, depending on a lot of different factors.

There was an existing force of UN peacekeepers in Haiti before the earthquake, but from what I understand they were mostly concentrated on the search for survivors and are now coordinating aid efforts. The US military has been controlling the airport and thus deciding who gets to land and who doesn't. I believe the seaport was destroyed and is largely unusable.

From what I can tell from news agencies, the Scientologists were allowed to land in Port-Au-Prince, rather than having to land in the Dominican Republic and truck themselves over to Haiti. One article mentioned that they brought drinking water and an x-ray machine, so the military might have decided to allow them to land for those supplies alone.

The television news broadcasts from Florida report as follows: JT's was the only civilian aircraft permitted to land, and it arrived with 4 tons of medical supplies, 24 doctors, and 3750 MREs. There was no mention of anyone returning back to Florida with John and Kelly.

WESH, WFPS

National Red Cross media spokesman Peter Teahen got the call to accompany (probably read: arrange) this trip over the weekend. He specified that he was doing it as a private individual and not as a representative of the Red Cross, but the news report identified him as such nonetheless. JT footed Teahen's bill for the trip.

KCRG

"Teahen, who is not a Scientologist, said the church has come to play a bigger and bigger role in disaster relief both internationally and in the United States."

but now consider myself a rational deist

Patrick, you may want to look up the meaning of the word "rational".

Someone just showed up in the NY Times Lede discussion of Scilon VMs in Haiti with this plug:

"After Katrina, we set up the Common Ground Health Clinic which offered free western and alternative health care. The value of alternative health care like massage, acupuncture or herbalism to me - a western trained nurse - is that the practitioners take time to be with the patient. The patient relaxes and focuses on their health. That human element of being present for someone who is suffering, is a valuable compliment to the western medical offerings people like me can give."

Common Ground Health Clinic
http://www.commongroundclinic.org/j15/index.php?option=com_content&view…ã=en

The website features many human/civil rights-type quotes, and text such as this:

"The practice of herbalism in a clinical setting is a many-faceted form of healing. In general, herbalism is a non-invasive, holistic practice, meaning that instead of and/or in addition to focusing on isolated ailments, the herbalist works with clients to treat the underlying causes and the whole person. Herbalists work primarily with whole plant medicines such as medicinal teas, tinctures (plant extracts made with alcohol, glycerin or vinegar), topical applications such as salves and ointments, and an array of others. Often, seemingly unrelated imbalances may all be improved with herbs that support entire body systems. In addition, characteristics such as body type, occupation and family life are often clues for the herbalist as to how best to help clients succeed in the healing process.

Herbalism is a practice that encourages, and indeed often requires, people to participate in their own healing. In this way it is an empowering modality, allowing people to become more self-reliant and informed about their bodies and their health."

The site also features many "donate" buttons.

This Mother Jones article from 2006 describes them as creating a new model of community health care. Extra points for vaccinating (!) Halliburton subcontractors, Acupuncturists Without Borders reference, and the overarching sense that they saw themselves not as medical providers as much as activists.
http://motherjones.com/politics/2006/03/street-samaritans

(Think the clinic recommends vaccinations now?)

This "participate in their own healing," "empowering modality," and "allowing people to become more self-reliant" thing really sticks in my craw(fish).

I just got an email from Ticketmonster informing me of a charity concert at the House of Blues starring Colbie Caillat, Brett Dennen plus others. Proceeds go to Real Medicine for Haiti.

The name set off my woo-dar, so I hit teh Googlz. Here's what I found: http://www.realmedicinefoundation.org/about/team_whole_health.asp

And lest I get caught in the url-trap, I encourage you to snoop through the rest of the site.

It's a good thing I don't like Colbie Caillat (or other milquetoast musics).

A slight O/T to pay my respects

Robert Minton, anti-Scientology Activist

Some comments observed via Twitter, from an infectious disease doctor named Megan Coffee:
"There is still a need for docs and nurses in Haiti. I hope people keep coming."

"The most common NGO shirt I see in Port Au Prince: Scientology"

"still confused why most common t shirt in hospital among health care workers is scientology."

"The ID doc in me is amazed: filariasis, tetanus and TSP. those were the first three diseases I was asked about today."

Gawker - Scientologists in Haiti - A Firsthand Account

"We've spoken to someone who traveled to Haiti on a Scientology plane â and witnessed firsthand the ineptitude, quackery and irresponsibility of the church's minions in a disaster zone. Here's his account."

London Times - Scientologists promise to stay after Port-au-Prince aid operation

Quote mine:
"Ms Harney said that the Scientologists were able to offer their own healing method in the hospital and in the clinic established by the University of Miami. âA person can be hurting and medical assistance does not work,â she said. âWe help people to locate themselves.â

The method, known as âassistâ might involve touching parts of the body or asking a patient to stare at a wall. âItâs a special Scientology technique developed by Mr Hubbard,â said Ms Harney, referring to the science-fiction writer L. Ron Hubbard, who founded the church in 1954.

Reports suggest that many injured Haitians have been grateful but bemused: an incomprehension that the Scientologists have attributed occasionally to the trauma that they are suffering."

Apologies for reviving an olde thread, but acupuncture anaesthesia is discussed in the above post, and this same subject came up in conversation recently. According to a friend acupuncture has been used as anaesthesia during c-section deliveries. I thought this sounded pretty unbelievable, but while investigating came across this abstract in pubmed: http://www.ncbi.nlm.nih.gov/pubmed/7431353

"The application of acupuncture anesthesia in obstetrics is discussed and reviewed. Of 14 patients delivered by cesarean section under acupuncture, 8 (57%) felt no pain, and 6 did not go through the entire procedure without other supplementary anesthesia. The failure and success rates are reviewed. It is suggested that the technique be evaluated further because with acupuncture the fetus and mother are completely protected from the secondary effects of general regional anesthesia."

I can't access the rest of the article myself and don't have the expertise to ascertain a good study from bad even if I could. All other references to acupuncture anaesthetic during c-sections refer back to this same study. Can anyone else access the study? Is it legit?

bump ^

My first reaction is that without the full article, it's impossible to evaluate meaningfully.

My second is that it's from 1980, so if it was really something it would have been more extensively followed up on long ago.

The current best data suggests that acupuncture is no more effective than tapping the skin in random locations with a toothpick. That said, there's supposedly research ongoing about using acupuncture for pain in battlefield scenarios. I find that disgraceful, myself, but if they find useful evidence I'd be willing to change my mind.

"My second is that it's from 1980, so if it was really something it would have been more extensively followed up on long ago."

Thanks Beamup, my thoughts exactly.

Studies like this tend to hang around as legends amongst the believers, however. To the person I was speaking with, this study lent real weight to acupuncture's supposed efficacy.

Given the time and place I can't help but wonder if the women were willing subjects (if the study did take place as described in the abstract).

Mephistopheles O'Brien:

"The current best data suggests that acupuncture is no more effective than tapping the skin in random locations with a toothpick. That said, there's supposedly research ongoing about using acupuncture for pain in battlefield scenarios. I find that disgraceful, myself, but if they find useful evidence I'd be willing to change my mind."

I agree. IMO the methods used in acupuncture for pain management are more or less pain distraction, couched in mystical descriptions of qi stagnation, etc. (I flirted with acupuncture in my 20s)

One of the points almost universally used for headaches is located in between the first and second metacarpal bones. If you massage in there you'll feel an achy spot along the [insert name of nerve here]. Imagine both these points being needled and stimulated (via acupuncturist or electroacupuncture) to the point where you can just tolerate it, for about 20mins along with whatever other points are selected. You pretty much forget about whatever other pain you have and just focus on the needles. The endorphin release leaves you feeling happy for a while after, until the pain comes back.