Medical Misinformation

Way back in the 1980’s, I was a resident in Family Medicine. Our training was a mix of hospital-based clinical training, rotating through all the usual specialties: internal medicine, pediatrics, surgery, obstetrics and gynecology, emergency medicine, etc.  Another significant part of our training was outpatient clinical work. We started slowly, one half day per week as first years, working up to 3-5 half day shifts by the time we finished three years later. The intent was to develop long term relationships with patients and families, so that by the time we were practicing on our own, we had a decent experiential base of both hospital practice and the day to day work of outpatient medical care.

Overall, this approach worked well. I did end up with many individuals and families that I worked with for all three years and I enjoyed the longitudinal relationships. An unexpected learning I had during this time was how to work with someone who brings in questions about treatment from unusual sources. I still recall one older woman, generally in good health, who saw me every 3 months for health maintenance and blood pressure checks. Not long into our relationship, it became obvious that she was a great reader of that fine medical journal and supermarket tabloid, The National Enquirer.

Nearly every visit, I was presented with a clipping from the Enquirer along with her question as to whether or not whatever was being espoused would be helpful to her. Now this was true diplomatic training. How to keep a straight face and not expound “WTF” or  “are you stupid?”.  If I had had my own genuine query met by such a response, I wouldn’t return, so why would she or any other patient?  I found that if I respected her question, looked at what was on offer, and sometimes it was perfectly reasonable, like exercise more or cut back on salt, then she would happily accept my opinion, which might also include something along the lines of “Your particular circumstances are different, I think the medication you’re currently taking is more suited to you.”

Fast forward to 2020, and the time of Coronavirus and Covid-19 infection. Globally, lives are disrupted, and while most who contract the infection do well and recover uneventfully, a significant percentage become very ill and die. It is scary, there is not a cure or vaccine, there is simply supportive treatment and avoiding exposure if at all possible. There is plenty of good scientific and medical information around, and there are plenty of questions as yet unanswered. When I was making rounds on individuals at our local Covid-19 recovery shelter, I often found myself responding “That’s a great question, and in about 2 years, I’ll have an answer for you.”

In this sort of a situation, people are frightened, some are quite desperate for hope and magic or miracle cures or preventatives. “Snake oil” salesman have long known this to be fertile ground. Hucksters and conmen of all stripes have offers. Unfortunately for the United States and the world at large, one of those hucksters happens to be president. Not only is he a con man, he also tends to ramble and muse and ponder crazy stuff whilst in front of a microphone. Hence recent horrible rambling statements about internal use of bleach or disinfectant or perhaps ultraviolet light. And of course, he’s been perseverating on hydroxychloroquine for a while, with the consequence that some individuals have died from ingesting the form designed for fish tanks, and people who actually use this somewhat toxic medication for their autoimmune conditions are having a hard time getting the treatment they need.

So this week, there are yet more scary headlines  Newsweek: Federal judge halts sale  of industrial bleach as Covid-19 cure from south Florida Church. Jim Bakker, a televangelist and convicted fraudster and scam artist, has gotten in trouble yet again for touting a silver based concoction as cure and prevention for Covid-19. He’s been dropped by his credit card processing companies and been issued warnings by both the FDA and FTC for his misleading advertisements of unproven treatments. Even the state of Missouri has sued Bakker for selling fake coronavirus cures. Bakker’s response: He’s told his faithful to send donations, he’s on the brink of bankruptcy, send money now. Save me!

Is it a coincidence that these “cures” come from fundamentalist type churches?  I doubt it. I am not a religious scholar, but one of the things I have noticed about fundamentalism of any stripe is its promise of certainty. Follow the rules and you’ll do okay.  Sort of a version of clean your room and you get your allowance, or a cookie, or whatever. In other words, “good” is rewarded and “bad” is punished. A very understandable way of being for the 2–5 year old set. Most of us love control, or at least an illusion of control. We want to be safe, however we define safe. We want guarantees.

As the Ben Franklin said: “In this world, nothing can be said to be certain except Death and Taxes.” I’ve modified it for years, you might be able to dodge paying some taxes, but its pretty clear you can’t dodge death. Life is a terminal condition, and a good many are struggling with that right now. We all tell ourselves stories, have our own imaginings about how things will end for us personally, or what we do or don’t want to happen, and then something like Covid-19 comes roaring through, awakening our fears. Internally come the screams of “its not fair” along with the reaction of it must be someone else’s fault, or there has to be a cure or preventative that I like. Enter those skilled at manipulating the fearful, with scapegoats and snake oil and all manner of scams.

I try to keep an open mind, not actually being a fan of big pharma and the reductionist mechanical medical model, but I am a stickler for facts and decent research. BS doesn’t cut it.

Individually and collectively, we are all being asked to grow up, and accept what really is. Including the facts that this infection is frightening, inconvenient and immensely costly on a great many levels, individually and collectively. The “miracle” we hope for isn’t going to be simple. We aren’t going to be the same going forward, why would we? That would be a failure to learn and grow. And meantime, use your head, meaning settle down a bit, think, and pay attention. Just because you want something to be true “do this and you’ll be safe from pain and harm” doesn’t mean it is true. Sorry kids.