Friday, February 3, 2017

Finding your way

Many of us believe in evidence-based medicine - I'm one such mind. There are some people who believe in alternative medicine, and sometimes appear to make decisions regarding their illnesses which are irrational. There are times when the two camps end up arguing rather forcefully.

There is, currently, a clever "story" that is making the rounds of certain circles. This "story" attempts to be, I think, a bit of a morality play. In the story, a "friend" gets cancer; chemo doesn't appear to work, his wife switches him to alternative treatments, he feels better. However, the cancer recurs, and he dies.

The moral of the story is that this person and his wife were idiots for embracing alternative treatments, when most likely chemo would have worked if they stuck it out.

I have a real problem with this "story."  The story is fictional; the person who wrote it, I believe, never had a spouse suffer from cancer. It's very easy to judge other people.

I'd like everybody to read the letter I have linked to here. This letter is from Robin William's widow, written as an open letter to neurologists. It's heartbreaking, a difficult read on many levels. 

However, notice how hard it was for her to make sense of the disease. It took her a full year after Robin's death to reach an understanding.

The diagnosis of cancer carries a lot of emotion; you will never how much emotion, and you will never how you will react, until you are confronted with it. While medicine has a much better understanding of some cancers, there is a mammoth communication gap between the oncologist / hematologist and the patient, along with the patient's family.

The family, I'm sure, in such a diagnosis, struggles to grasp what is taking place. They struggle to understand what is happening to the patient. They struggle to find a way to help.

I can certainly understand why these struggles might lead to embracing alternative medicine. I've made quite a significant investment in understanding the traditional, evidence-based medicine regarding myelofibrosis. This was one of the hardest research projects I have undertaken, and I'm just starting to scratch the surface of how hematopoiesis works; how it breaks, the role of stem cells, the bone marrow niche, signalling, gene expression, and how all these pieces of the puzzle fit together.

I'm certain that calling people who turn to alternative medicine in the hopes of helping their loved one "idiots", "stupid", or "fucktards" doesn't help anybody. I'm sure that clever stories don't help the people who need help. 

In brief, we all must find our way. Sometimes, we choose the wrong path, and must backtrack to the last place we planted a marker. Sometimes we make sudden, unexpected progress. One thing that seems to be true: never does the battle proceed according to plan.


We must adapt, struggle, continue the battle, and persevere. Otherwise, we have lost the war.