Health and humanism

500px-CaduceusThere are a lot of labels out there on which I could hang my belief system, but let’s call it humanism. Who can argue with a human being, being a humanist? Richard Dawkins has ruined atheist for some of us, skeptic feels like an anti-something rather than a pro-scientific method something, and humanist captures the range of beliefs nicely with the added benefit that many people only have the vaguest idea what it means.

I have no interest in converting others to my beliefs, or persuading people out of theirs, which means labelling myself doesn’t come up all that often anyway. I try to respect others’ beliefs and try not to give them a reason to disrespect my own. It doesn’t take many “you’re a nice person for an atheist” or “you don’t believe in anything” comments to feel it’s not worth it to start from scratch with people who aren’t really asking what I think anyway.

Whatever you call them, those beliefs mean it goes against the grain that I’ve started to see a naturopath. Even more so that it’s been a very positive experience so far. I generally agree with today’s Timothy Caulfield Toronto Star piece:

Naturopathic medicine, despite its claims to the contrary, is not evidence-based. Given this reality, provincial health ministries need to carefully consider the long-term implications — including the legal and ethical challenges — of formally legitimizing the pseudo-scientific.

I chose a naturopath who does not believe in homeopathy or other “energy healing” systems. She’s a PubMed junkie and so far the supplements she’s recommended check out as having some scientific credence.

She believes there are times when a conventional doctor is the best choice, and especially given that she hasn’t done a physical examination in my three visits so far, I don’t consider her my primary practitioner. (The fact that I haven’t seen my primary practitioner in a few years, and only a handful of times in the 10 years I’ve been in Vancouver, is a minor detail — if I had major concerns about my health I’d be making an appointment.)

I like that the naturopath has time to listen about the scope of my life and my health. Because of the way GPs are paid that’s not usual of a family doctor. If British Columbia had Nurse Practitioners available for the general public I’d be all over that, but a naturopath whose beliefs mesh with my own seemed like a good alternative.

So while I’m happy with the alternative health care experience so far, it’s a happiness tempered with dissatisfaction with my experiences in the primary care system. The last time I was at my GP’s office was for the same complaint that drove me to a naturopath recently: insomnia.

The GP — who, if she’d read my chart, knows there’s severe mental illness and depression in my family history — asked me if I was depressed. I said “I don’t think so” and she immediately gave me a prescription for enough sleeping pills to kill me several times over. She also told me they weren’t addictive and I could take them as often as I needed. The product monograph disagreed. I wanted the pills — at the time I was working on the Olympics and needed a quick fix — but I’m also lucky that I’m not suicidal and am smart enough to disbelieve there are magic sleeping pills with no side effects. That visit took 5 minutes. The pills worked.

The naturopath talked to me at length about my health and state of mind, and gave me behavioural guidance and supplements that have proved more beneficial than the melatonin I’d been taking, and at least as effective as those sleeping pills. A miracle? No. Placebo? Maybe, but PubMed does agree with her that there’s evidence to support them, and what do I care as long as I’m safely getting more sleep. (Safely is debatable with supplements too, but I just have to trust the higher-grade version is better than store brand.)

So I can both agree with Caulfield and wish there were an answer somewhere between “fix the public primary care system” — which will take considerable time and effort, and some of us need our sleep in the meantime — and “give pseudo-science equal footing with science.” He says:

I am fully aware of the many deficiencies of conventional medicine, including the perverting influence of commercial forces and the lack of good evidence to support many common practices and therapies. Also, many Canadians are not satisfied with their interactions with conventional practitioners, which they find too brief, mechanical and impersonal. These issues need to be addressed.

But the response to the problems of conventional medicine should not lead us to the embrace of pseudo-science. As nicely summarized by well-known science advocate Ben Goldacre, a flaw in aircraft design does not mean we should turn to magic carpets.

I feel lucky that I’m both healthy enough so far that I haven’t had to test the naturopath/physician duality very hard, and that I found a naturopath who — whether she’d use the label or not — is more humanist than magic carpet enthusiast. But it would be nice to take luck out of our medical equation as much as possible.

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