A dear friend of mine is about to enter a prestigious program of naturopathic medicine. There—in exchange for hundreds of thousands of dollars and five years of his life—he will study homeopathy, osteopathy, water therapy, etc. Apparently, after gaining his ND credential, he will not only be allowed to practice medicine in Washington, but also to prescribe drugs. Why does state law allow these practitioners to dole out the pills? Can this possibly be safe?

Incredulous Friend

P.S. Is there a polite way to tell someone that everything he passionately believes in is bunk and that he’s throwing his life away?

I disagreed with the questioner; a lot of alternative medicine is worthwhile, and increasingly demonstrated to be so by the scientific method.

Fortunately, not all of naturopathic medicine is bunk….The less a branch of naturopathic medicine defines itself as being in opposition to “allopathic medicine” (i.e., scientific medicine), the more useful it seems to be for patients. Most massage therapists or acupuncturists will gladly admit the limits of their techniques, and the benefits from receiving treatment from either can be scientifically demonstrated. For things like chronic back pain, arguably these practitioners will be of more use to a patient than a doctor armed with pills and surgery. Training in osteopathy is becoming ever closer to the curriculum one would find in a medical school; Science would trust an osteopath as a primary caregiver as much as an MD.

Only when the naturopathic fields refuse to have their claims tested by experimentation does Science find them to be silly or even fraudulent.

This position–that an ND curriculum based upon science is as valid as one taught at a traditional medical school–is a bit out there, a more generous stance in favor than typical for naturopathic medicine.

The response from the local ND community? Emails like these:

First problem: it is an opinion dressed in an article called ‘Science.’ That is shitty science. It is also crappy journalism to advance opinion as fact. Some simple searches on PubMed would have improved the entire article, or maybe call a few people with credentials like Dan Savage does.

Bigger problem: Bastyr University pays the Stranger for ad space. Obviously, you print what you think is important and everybody is better off because censorship creates fear and drones. However, I think taking money from a University for ad space and bashing them in an opinion-laden article passed as Science is low. It is one thing to take ads for cigarettes and then criticize, but Naturopathy is not cigarettes, it leads to health not health problems.

You paper shapes peoples opinions. Do you really want to suggest that current medical practices are ideal? Do you want to discredit the ND’s who heal while not partaking in the fraud that is our current healthcare system and medical practice? I would like you to publish articles on ‘iatrogenic’ disease. There is a story.

Ugh.

Modern medicine works because of a long legacy of scientific inquiry to human health–from peer-reviewed, double-blind, randomized and controlled trials to simple correlations of observations to disease states. After pulling out the horrors of our employer-based private insurance system, for-profit hospitals and other aggravations, this body of knowledge– continually expanded, pruned and refined–is the basis for the dramatic successes of a deeply flawed health care system.

Take Evidenced-Based Physical Diagnosis, written by a Seattle VA doctor Steven McGee, as an exemplar example. Any caregiver (MD, ND, DO, whatever) with this book, or similar, in their mind is skittering on top of a vast and precise body of knowledge that has taken centuries to accumulate. This collection of carefully curated information, that some of my ND readers are ready to call fraudulent, is beautiful and scientific in the deepest sense of the word. To the extent that alternative caregivers are contributing to it–using differing philosophies and point of view to open whole new areas to observation–they deserve a warm embrace. To the extent they are furiously, blindly and stupidly lashing out at it, they are the enemies of health.

Dear Science,

I recently read your response to Bothered Bowels’ inquiry from 2/13/2008. Sadly, BB is not alone. I actually know several people who experience this same issue, most with #2, but others with #1. Indeed, it particularly occurs at Value Village, libraries, bookstores, and also when shopping to CD’s. I find your Pavlovian theory rather interesting and plausible, but I would like to be so bold as to add a comment.

The common theme for BB and others like him/her seems to be situations that involve the act of browsing. Is there something relaxing about the process of roaming through large spaces while searching for non-specific items of marginal necessity that activates the parasympathetic nervous symptom and its associated “urges”?

Or, could it be that people are more likely to have downed a cup of coffee shortly before entering one of these establishments?

Thanks for your excellent column,
Laurie

Laurie,

I like your theories as well. I almost always have to pee after public speaking–I figure from the loss of sympathetic tone from the relief of it finally being over allows my bladder to reassert itself.

Coffee is a sympathomimetic, forcing the activation of the wrong side of the autonomic nervous system. But it’s also a diuretic, causing you to have to pee. More research is warranted.

Thanks for reading and writing!

- Jonathan (aka Science)

(Don’t forget to check out the podcast for this column, one of my all-time favorites!)

Could I found a company in Lake Union? In Seattle? In the region? Finding a vacant warehouse, sweeping out the rats and installing some desks won’t cut it. Like any biotech start-up, I’ll need lab space, with specialized equipment, air handling and utility support. Some fee-for-service cores, for things like DNA sequencing or animal handling, are essential. So is access to a proper academic library—remember, most journal articles are subscription only.

Very little of the built or planned lab space in Lake Union is set up like this. The “biotech incubator” facilities on Eastlake—not technically in SLU—are woefully inadequate. Nor are the support services in the pipeline. Without some far better developed incubator space for start-ups, the neighborhood will fail as a biotech hub. Period.

UW is already the largest single employer in the city. Do you honestly think the most talented faculty will stick around without the ability to start companies and fully develop ideas? This isn’t a matter of real-estate or making a lovely neighborhood of near-downtown housing. This should be about economic development.

Think I’m just being a whiner? Check out New York City’s biotech plan. That is serious, and likely to succeed despite serious disadvantages relative to Seattle. Ours is a joke in comparison.

From Tom Robey at Hope for Pandora brought up some interesting points:

For reference, 5 mg is 1% of what mercury thermometers contained. Yes there IS mercury, so you should follow these instructions in the rare event that a bulb breaks.

So, this is where I should come clean; every lightbulb in my house is a compact fluorescent. When I moved (about a year and a half ago) I converted over. Since then, I’ve broken a bulb, and had to deal with the hassle of cleaning up mercury from my household. I stand by my assertion in the column. Mercury is a serious neurotoxin; most modern thermometers have converted over to alcohol as a result. Bulbs break. I’d say, if you have a heavily used bulb that is out of reach, it is probably safe. For floor-level lamps, children’s rooms or seldom used light, stick with tungsten.

We do use water to fuel our consumptive power habits, but what about all of those folks in Wyoming or Michigan that burn coal? If we don’t use our extra power here, guess who we sell it to?

We must consider the cost of transmitting electricity. A significant portion of the power would be used up just getting it to Wyoming or Michigan. So, while the Pacific Northwest does sell electricity to California, less power consumed here does not automatically translate to less coal consumed elsewhere.

n the United States, use this helpful guide to find out where your bulbs should be disposed of. In Seattle, go here or here.

Strictly speaking, Tom is correct here. CFLs can be properly disposed of in most places — as hazardous waste. That’s a long way from recycling the mercury and other toxins in these bulbs. I suspect that a great deal of even “properly” disposed bulbs will end up leaching heavy metals into drinking water.

How many home owners will go through the hassle of making an appointment and transferring used bulbs to a hazardous waste pickup site — no more than a handful at a time please! Most will end up in the regular trash.

From e-mail:

You rightly illuminated several of the grievous shortcomings of the fluorescent (and compact fluorescent… the spiral ones) bulbs. But what about LED (light emitting diode) bulbs? Although they are a bit premature for prime time due to cost, they are still super cool. Really. Unlike traditional “heat-bulbs,” >90% of the electricity sent to LED bulbs becomes light.

I like the LED bulbs as well. They’re even more efficient than CFLs, energy wise and avoid most of the toxic heavy metals. Still, have you seen the light from these bulbs? The colors are even worse than those from CFLs.