Guinea Pig? Or Master of the Universe?
(October 13, 2020)
Not too long ago a pet peeve of mine was triggered. This happens a lot, and out of pity and charity I usually spare you all the rant that follows. But this one I must share, because it was about something health related. Specifically, it was regarding the brouhaha about the president getting an experimental treatment for covid-19. (NO POLITICS AHEAD, YOU CAN KEEP READING.)
There was a lot of yammering in the internet universe regarding this, mostly about privilege, and access, and privileged access, and the like, none of which I will take issue with because 1) they are irrelevant to my topic and 2) because only the dimmest bulb in the chandelier would try to argue that money and connections mean nothing in America. But to my mind, all that agonizing was unnecessary because it was based on a very starry-eyed, common, and false assumption -- that experimental treatments are miraculous cure-alls.
No one ever says this in so many words, of course, because as soon as you do you can hear immediately how stupid it is. But almost everyone believes it. At least your non-medical types do. That's because there are about a zillion movies (not to mention women's magazines, mommy blogs, and romance novels) where someone very appealing is snatched from the jaws of death by an experimental treatment. Conventional methods have failed and all hope is gone except for this one remaining bit of magical thinking. Because that's all this outsize adoration of experimental treatments is -- magical thinking.
Now, it's true that every genuinely effective treatment WAS at one time an experimental treatment. But that's not an especially meaningful point, because most experimental treatments never make it all the way through the testing process to become accepted as a proper and regular treatment. Even the ones that sound really, really good usually fall by the wayside. Any established treatment for something (if there is one) is always going to be your best bet over an experimental one, because guess why? WE ALREADY KNOW THAT IT WORKS!
Experimental treatments are no more than someone's bright idea. When they finally make it as far as testing to see if they actually work, they are compared to two things -- treatments that are known to work, and no treatment at all. And if said experimental treatment can't produce better results than the other two can, they are mercilessly trashed.
When you try an experimental treatment, it hasn't been through those fires yet. You have no idea if it will help you, do nothing, or make you Patient Zero of the zombie apocalypse. Everything else being equal, stick with what you know works.
Of course there are some conditions for which there is no conventional treatment. So if that's the case, is an experimental or unproven treatment your best bet? Most people say "yeah, because anything is better than nothing". But that is not correct.
Neglecting to apply external curatives to a health issue is NOT the same as doing nothing. Not treating a condition is actually letting your body do the job on its own, which is about as far from Nothing as can be imagined. You're only here because evolution has given you a body that, over billions of years, has developed remarkable mechanisms to, completely on its own, automatically handle everything that nature throws at it. If it hadn't, you would not be here. You would have died before you got a chance to reproduce and that would mean that you failed.
YOU may think that you haven't failed just because you didn't reproduce. Evolution begs to differ. If you don't pass on your genes to the next generation, as far as evolution is concerned you are a waste of living tissue. It is totally disgusted with you, and its punishment is that it consigns you to genetic oblivion. If you can't or won't reproduce, your genetic complement is an evolutionary dead end. The Darwin Awards are not just snark -- they encapsulate the viewpoint of the drive to survive of the species. If you were so stupid or incompetent as to not reproduce, says evolution, what is the point of you?
Because it wants you to survive to reproduce, then, evolution has spent billions of years evolving mechanisms to see to it that you do. And if those mechanisms weren't far more fabulous and fantastic than anything a bad Hollywood screenwriter could imagine, we wouldn't be here at all.
The immune system is extraordinarily brilliant in both concept and execution, and the inflammatory/repair system is no less awe-inspiring. Letting those things have their head is not "doing nothing". It is a genuine option for healing, and very often the best one.
There's a Russian proverb that goes something like, a drowning man will grab at a double-edged sword. If you're really drowning, yeah ok. But if you're not actually about to be swamped by a wave for the very last time, keep paddling. Experimental treatments are how we find treatments good enough to become part of the system. They are not true treatments until they pass very rigid testing. So don't be impressed by their gilt and flash and never ever rank them above what we know already works.
--dr. diane holmes
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