19 responses to “Not in the stars, but in ourselves”

  1. firepower

    This was really good.

  2. judgefudge

    While your post seems to address the concept of ignorant-population assigning nebulous diseases to nebulous causes, care must be taken to ensure that the scientific community also applies a level of rigor in classification. Too often, diseases which have similar symptoms are assigned under the aegis of nebulous-disease-du-jour. A good case in point would be “irritable bowel syndrome.”

    I can offer a firsthand family example which shows both laziness on the part of the health care provider and how easily it is to fall into the trap of assigning causality where there is none. My first cousin was not developing properly, mentally. His attention and speech and reaction to stimuli were severely, severely off. The doctors immediately said “He’s autistic, there’s no cure, here is some literature on dealing with an autistic child.” My aunt, who is stubborn, refused to believe the diagnosis, though a second, third and … nth opinion seemed to confirm it.

    She ended up reading some of the alt-health literature that purported a link between an allergy to, say, gluten or casein or god knows what, that causes some sort of [hand waving about inflammation or problems with proteins or something] which equaled autism. She experimented with different combinations, and in the end, after removing wheat gluten and milk from his diet (rice turned out to be okay) he developed normally and is actually a bright young kid at the moment.

    This is in no way a defense of the “allergies to common foods = autism” theory. I don’t necessarily buy that because I haven’t seen hard science back it up. What I will claim is that some sort of allergy to food was impairing his cognitive development. The question, and this is one only rigorous testing can shed light on, is whether this condition is equal to autism. Not equivalent, not similar, not tantamount: is what my cousin experienced autism. Only when this first principle is established can the claims of etiology be visited.

    Thus, there has to be special care taken on the provider’s side to not abuse the establishment of this first principle, the diagnosis, out of laziness. If the doctor says “This is similar to autism” or “This might be autism” or “This could be autism” or “I don’t know”, then finding out that a certain therapy may or may not work IN THAT CASE can not be easily applied as a generality. When a doctor is lazy and says “It’s autism” without more probing, then if removal or addition of a certain X-factor (gluten, milk, chicken soup, greased-up dildos, whatever) is going to stick in people’s minds as being applied to the general disease. With diseases that are poorly understood or which apply to an entire spectrum, the risk of this happening is more likely.

    If I may toot my own horn here, this is part of the project on which I work. I work in the military health care arena, and one of the tools we’re working on is a giant database of patient information that allows searching and cross-referencing by SYMPTOM as opposed to DIAGNOSIS (though it is possible to search by diagnosis as well). This is important because many diseases share similar symptoms. For example, flu, salmonella, various bacterial infections, and various viral poxes will cause fever, chills and muscle aches. The treatment method is not necessarily identical. Nor should it be.

    For the record, I don’t think my cousin had autism.

    1. etb

      While your post seems to address the concept of ignorant-population assigning nebulous diseases to nebulous causes, care must be taken to ensure that the scientific community also applies a level of rigor in classification. Too often, diseases which have similar symptoms are assigned under the aegis of nebulous-disease-du-jour. A good case in point would be “irritable bowel syndrome.”

      Diagnoses like IBS are rather bogus, but I’m not sure what else you can do. If you don’t give it a name, it gets even less attention, and it’s hard to subclassify when you have no clue what causes it. Now they talk about “post-infection IBS-D” because they have one or two clues.

      IBS also seems to be an example of how, if you (society, the establishment) can’t ascribe a socially determined cause, and have no clue what the cause actually is, you can at least ascribe a mental one without evidence, dismissing IBS as being “ALL IN UR HEAD!!1!!copter”. Of course now there’s evidence that hypnosis often works rather well on IBS, so something with the head is going on (something more than you’d expect with any disease) but that’s a relatively recent discovery.

  3. ofmonsters

    I posted about this exact topic on my MS blog less than a week ago.

  4. nyxie

    I should print this and present it to a few colleagues of mine who need to hear it. ;)

    Also, I must read Illness as a Metaphor.

  5. anemone

    This is wonderful.

    However, in this otherwise great post, I was bothered to read that “white sugar and honey will give you the exact same diabetes.” Sugar does not cause diabetes, at least according to the American Diabetes Association (see myth #3 on http://www.diabetes.org/diabetes-myths.jsp). If you have evidence to the contrary, I’d be delighted to hear it.

  6. sakkaranoush

    Excellently written! I really enjoyed your post.

  7. planetdracula

    really great post – I balanced a salt crystal on my screen while reading to offset the toxins though, hope you don’t mind

    1. planetdracula

      (although: as an ex-psych nurse, I will rep for stress – not “being stressed out,” but actual stress, which is a definable physical event – as a huge contributor to/complicating factor in many, many medical conditions)

      1. moniker

        I’m in a weight management program where they talk about “stress” as an inhibitor to weight loss. But it’s never just “stress is bad for you and makes you fat”. It’s always presented as “stress causes these bodily reactions and this hormone release, and we know that these impact your metabolism in this way”.

        Similarly with “not getting enough sleep”, “eating too much refined carbohydrate”, “overdosing on saturated fat”, and “food sensitivity”; they are constantly reminding us that being overweight is not a reflection on us morally, but is a condition which has a bunch of underlying hormonal and metabolic factors, most of which can be managed.

        I’m lucky that I don’t have a thyroid or other serious endocrine problem that causes weight gain. I don’t know how they handle those edge cases.

  8. hotelsamurai

    One thing I’ve always wondered about “processed food” and the supposed evils thereof: what do we mean by “processed”? Does that include toast?

    Because toast, ya know, is just a slice of bread that’s been, uh, processed.

  9. kasheri

    This brought to mind a thing that troubles me, and that I see as the opposite side of the same coin you’re talking about here. That is, the idea that moral rectitude is a balm to prevent illness. For example, it is so often that when it is announced that someone has cancer, people will respond with, “But he exercised daily!” or “But she always ate such a healthy diet! She wasn’t a pound overweight!” Diet and exercise are frequently considered morally good. (If your vice is greed, it’s all good. If your vice is sloth or gluttony, you deserve whatever you get.)

    You might find Emily Martin’s work interesting. She works on the anthropology of medicine. Her book “The Woman In the Body: A Cultural Analysis of Reproduction” is groundbreaking and eye opening. I’ve been meaning to read “Bipolar Expeditions: Mania and Depression in American Culture.” I’m confident that it will be fascinating.

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