Self-Observation; how I learned not to trust myself and you shouldn’t either.

This is in essence a very long response to Sarah Hemple’s comment on the Ockamist.

Holistic medicine

I completely agree that a balanced diet, exercise, etc all amount to a solid disease prevention strategy. However, I completely object to the characterization of western medicine as somehow inferior in holistic/wellness issues. Certainly my view is somewhat slanted because my family consists mostly of DO’s and biomedical engineers who tend to view treatment holistically, but I’ve never been to a physician that did NOT inquire about wellness concerns of balanced diet, exercise, and substance abuse. Western medicine is increasingly wellness oriented, if anything I would consider the restraining factor to be insurance companies not the medical professionals.

<>Self-Observation

I have no respect, other than as amusing reading, for non-double blind self-observation in medical treatment. I am completely convinced that completely rational individuals cannot observe their own medical reactions objectively. Even if the observation is of a laboratory experiment that has nothing to do with personal health, bias and emotion plays a powerful role…I’ve learned this the hard way a couple of times in physics and engineering, where despite my best efforts, I observed what I expected rather than what was actually there (notably, I once measured velocities for non-existent Milikan oil drops, probably picking dust particles in the microscope…and, surprise, surprise, I calculated a nearly correct value for the experiment.…).`

<>I firmly believe that there is a reverse placebo effect where completely rational and intelligent persons either suffer “medical student hypochondria”, or merely observe side effects suggested by reading the packaging inserts. If medical students, future doctors, with highly honed science backgrounds and powers of observations suffer objectivity problems and report symptoms of diseases they DO NOT have due to suggestion; the rest of us are certainly fallible as well. I have no respect, other than as amusing reading, for non-double blind self-observation in science. In my mind, an assumption of fallibility of an individual’s observations is the basis of all experimental design.

In other words, if one reads jitteriness on a prescribing insert for Allegra, or hears about it from friends or on the Internet, they have a wildly increased chance of noticing jitteriness. If, one read an equivalent side effect sheet on an herbal…since Sarah kindly brought up it up, why not St. John’s Wort, which has pretty stiff side effects, they might well experience those symptoms.

A question to those who would defend self-observation on holistic grounds…(i.e. what makes you feel good is good medicine), can you still object to patent medicines that depended entirely on placebo effect combined with low doses of mild intoxicants (alcohol, opium, hash oil, ether)?

Finally, I’m willing to argue all of Sarah Hemple’s generalizations about specific drugs; example: sure antibiotics can cause yeast infections, but how often, how severe, and whether that’s preferable to the original condition is debatable. I’m not going to write a 7,000 word detailed paper on the different types of antibiotics, etc, but if anyone wants to argue with specifics and cites, I’m ready. Want to argue effectiveness, in double blind testing, of herbal “x” v. pham. Drug “y”, and compare side effects, I’m willing to discuss it. What I don’t want to do is argue against unsupported on non-specific generalizations, i.e. “Anti-depressants cause anti-personality, St. John's wort actually works and so does exercise.” Along the same lines, I coiuld say, St. John's Wort causes high blood pressure, nausea, and completel dementia if you take imodium or pepto-bismal while on it...but I do not want to generalize a rare side effect into "causes".