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Archive for June, 2007

Walking is good for you (but how can you be convinced?)

Posted in from the reading room, health on June 3, 2007| 3 Comments »

A BMJ-published study from the Scottish Physical Activity Research Collaboration has focussed not on the fact that walking 30 minutes every day will significantly reduce your chances of suffering from several diseases (potentially halving heart disease risk for example) but on how to motivate people to act on this advice.

What would it take for YOU to change your habits and walk for 30 minutes every day?  The answer is interesting –

Our findings are consistent with (but certainly not proof of) an assumption that different types of people may respond to different approaches, tailored to their psychological characteristics or life circumstances. In other words, one size may not fit all and various approaches should be offered: some people may respond best to personal advice from their doctor, others may prefer the private feedback from a device such as a pedometer, others (perhaps those in a more advantaged socioeconomic position) may benefit from interventions delivered through the internet, others may benefit from the social support of a walking group, and others may increase their walking in response to prompts about reducing their car use on environmental grounds.

In other words, what works for one person doesn’t work for another and if we want to help people we need to both actually communicate with them to find out a bit more about them, and then tailor our advice to best suit the individual.

This kind of study gives me hope. For too long Medicine has focussed on disease and then tried to treat every patient with the same disease in the same way, but we are beginning to see the glimmers of the New Medicine which focusses on the individual and tailors the treatments according to the individual’s uniqueness.

This is a move from Zombie Medicine (unthinking, treat everyone the same) to Hero Medicine (thinking, holistic and individualised)

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“Novel” treatments?

Posted in education, from the reading room, health, science on June 3, 2007| 2 Comments »

A three year study of treatment for “acute promyelocytic leukemia” adding arsenic into the mix has shown that doing this can increase the survival rates significantly.
What really struck me in this story though was this comment by the Reuters journalist –

Arsenic has been used as a traditional therapy in China for more than 2,000 years, but its use in the United States is still rather novel.

Why is that? What is it about the tendency to certainty in Western thinking? I suppose we have a long history of believing we are right and that our ways are best. We live in a chaotic world where chance events change people’s lives forever every single day. When it comes down to the individual all the so-called certainty of our statistics-focussed view of the world is of little use. When I meet a patient with disease X, I have no way of telling whether or not they will CERTAINLY respond to the same treatment as other patients with the same disease, nor of knowing EXACTLY what will lie ahead for them. But as human beings we can’t cope with total chaos, and complete uncertainty. We need to have some idea of what’s happening in our lives and some idea of how things MAY turn out with particular choices we make. That’s just how we are. We need to juggle our knowledge of uncertainty and unpredictability of the particular with our knowledge of probability gained from the general. The problems arise once we turn those probabilities into certainties.
There was an interesting line of dialogue in CSI the other night – one character, a forensic scientist, said “I am confused”, and her boss replied “Good. That’s the best place for a scientist to be”. He was SO right. Well, not that scientists should always be confused but a scientist who stops doubting, stops looking and stops thinking.
Wouldn’t it be a good thing for us to look outside of our little boxes and see what phenomena are actually already well-observed (just by other people in other places – people who think differently from “us”)

I’m a homeopathic doctor and homeopathic arsenic was the very first remedy I had success with. Whether or not you believe in homeopathy, one thing a study of the subject brings is a greatly increased knowledge of substances used medicinally in different cultures over the centuries. It’s well known to homeopathic doctors that arsenic has traditionally been used to increase stamina and staying power (in fact, it was used to do just that in racing horses until it was made illegal!)  It’s also well known to us that arsenic is a commonly indicated homeopathic palliative treatment in cancer.

I wish we could replace the arrogant know-it-all and I-know-best in scientists and doctors with an attitude of lifelong curiosity and wonder.

What do you think? How would you change the education of scientists and doctors to increase open-mindedness, creative thinking and foster a spirit of humble, endless curiosity?

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