Thursday, September 28, 2006

Sister Fortune

Every day on the way to work I pass an interesting little business. The front window has a couple neon lights that spell out 'Tarot Cards' and 'ESP'. The sign by the highway reads "Sister Liz: Psychic Readings and Advisor". The interesting thing about this is that there are always one or two cars parked out front. Whenever I see this I wonder how many of Sister Liz's clients are also seeing a psychiatrist---or not seeing the psychiatrist they need---and what other alternative treatments they are using. For the most part I don't think a consultation with Sister Liz would do any particular harm other than thinning one's pocketbook. Who am I to complain about a gypsy fortune teller? There are scads of healing paradigms to choose from: chiropractic, aromatherapy, accupuncture, Chinese herbalism, "root" workers, sweat lodge, exorcism, ayurvedic medicine, meridian therapy and even angel adjustment. People talk about rising health care costs, but alternative treatments can be fairly pricey too. Regardless, I think that if they're paying out-of-pocket it's up to them what kind of consultant they see.

My main bone of contention is the use of the term 'complementary' medicine. According to (my favorite source of all things lexicographal) the term 'complementary' means supplying mutual needs or something that completes the whole. The implication is that complements, when combined, offset one another or blend to create a unified whole. Nice idea, but hooey when it comes to medicine. Aromatherapy has as much relevance to traditional medicine as tanks have to gardening. The National Institute of Health has a branch dedicated to studying alternative and complementary therapies of many kinds but it seems to me that the number of proposed therapeutic modalities are growing faster than they can possibly be validated. And as far as I've seen they're not funding any clinical studies on the effects of fortune tellers or exorcists.

Separate from efficacy issues---or lack thereof---there's the question of potential harm. In one study done in Boston, a random sampling of ayurvedic medicines sold in the Boston area revealed that 20% of these compounds were contaminated with heavy metals such as arsenic and lead. There are over a thousand publications in PubMed related to herbal remedies alone; many of these are case reports of serious complications from these interventions.

I'm sure there are many reasons why people don't pursue traditional medicine---lack of finances, fear and trust issues or cultural affiliation---but this does not lessen our obligation to ensure safety and efficacy. And that can't be done by looking in a crystal ball.