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I'm with you! Oh wait, not that far.

I often find myself in an awkward situation. Awkward to me anyway. Ok, I find myself in many awkward situations: it's kind of my thing. But this specific kind of awkward situation happens when I find out the person I have been agreeing with for the past hour/month/year has gone way too far down the rabbit hole. I don't mean they are crazy, just that they have some ideas or theories which they hold dear and which I find completely unsupportable. Though it can and does happen in many area of life, I'll pick an example from the world of medical beliefs, because I run into those quite frequently, and I find them the most frustrating.

Suppose you have been talking with someone at a party about cholesterol (hey, it happens when you get older), and have been discussing your mutual disdain for doctors who push cholesterol medications on people who probably just need to eat better and exercise, and how the evidence for statins helping people who don't have heart disease is quite limited, and how the basic science is still being done, and a bunch of other things that go against "conventional wisdom". You are in complete agreement: sometimes doctors do not know what they are talking about.

Slowly, things take a weird turn. Your confederate in reasonable thinking starts dropping odd hints of conspiracies. Phrases like "allopathic" and "big pharma" start being thrown into the conversation. Soon, it comes out that they take 50 supplements a day "to boost their immune system". They believe almost all drugs are not needed and are, in fact, merely profit devices. And finally, they fully accept a plethora of alternative medicine genres, believing the alternative practitioners to be the "real experts"…

Ya see, I was with you. I, too, reject the notion that doctors and medical science have all the answers: there are so many things yet to be discovered about health, and doctors are just puny humans. I, too, reject the notion that doctors can't be wrong: they often are. I, too, agree that a one-size-fits-all policy doesn't work in many situations. I agree the doctors often just want to play it safe to avoid getting sued, so they prescribe something and get to the next patient. I agree with you on many things like that: many times what passes for medical knowledge is not that great. I agree.

This person had made it to a perfectly rational place: a place where you might say "My doctor said something, but, looking at the actual knowledge available, there's no good reason to believe it." I'm there, entirely. An example: Our daughter had a cold with a lot of phlegm, and one morning was crying about her ear hurting. My wife took her to the doctor that very day, because ovaries, that's why. The doctor ran no tests, just asked about the pain, pronounced it an ear infection, and prescribed a 10-day course of strong antibiotics. I found that a bit premature. I looked up what information was available, and saw there was little danger in waiting a day before starting the course. The next morning there was no pain, and most of her other symptoms were gone too. Was it just a clogged tube? Who knows. I do know we saved her from 10 days of needless and potentially harmful medication.

See, I'm with you. Doctors often are merely guessing and/or trying to get to the next patient. Got it. Doctors overprescribe medications to placate nervous patients or worried parents? Totally, I'm with you 100%. A doctor might try to pad out a bill with a needless treatment or the equivalent of a placebo? Quite possibly. Doctors, the AMA, the FDA, the USDA, universities, researches, foreign governments, etc are part of a giant conspiracy with the pharmaceutical industry to sell drugs they know are both unnecessary and dangerous to unsuspecting rubes… not so much.

"But", you say, with that 'oh, how naive' look in your eyes, "the evidence is suppressed by the FDA/AMA/doctors/etc." That's great and all, but that still means you have no evidence, and it means you have great faith in the competence of government agencies.

Can doctors be incompetent? Yes. Can they sometimes make mistakes? Uh huh. Can they be greedy? Yup. Can they do unethical things? Yessiree. Can people in a federal agency be incompetent or corrupt. Absolutely. Has this happened in the past? Most certainly… But… Is there any evidence for this specific thing we are talking about now? I'd love to see it. I'd love to believe it. It wouldn't even surprise me much, after all: these things do happen. But, without evidence, I can't jump headfirst through your conspiracy-tinted looking glass.

A final, quick example, I can both:

  1. believe that the evidence of effectiveness of fluoride in the water supply is not that great
  2. and not see any reason to believe that it's some sort of nefarious conspiracy involving the mining industry.

I'm not sure why others can't do the same.

2012-07-21
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