drieuxster (drieuxster) wrote,
drieuxster
drieuxster

Evidence based medicine v. the refudiated science based medicine

At one end of this posting is the FRIGHTFUL moment of the clearly ParaOatmealisms of my EvilHouseMate, who was not willing to cope with the psychoComplications of how not to confuse issues of 'medicine' and those of, well, 'pop psychology'. I should of course demure and note that EvilHM was polite enough to note that my experiences with the psychiatric industry were, well, different than most pedestrian approaches to the industrial failures. I should likewise note that I was raising the delta's that come when one is discussing 'suffering' as a loose cannon rolling around the good ship lollyPlopPlopPhizPhiz when we want it to mean a wide and elastic collection of symptoms free standing from any actual pathology.

Oh me, oh my, I am frightened to find that 'pathology' is a technical term that relates to the study of the root causes of actual diseases and is not the study of the pathetic and emo! Oh dear, what ever will I do now? ( for our slow readers, I am making the clear and compelling distinction here between the term in it's use in clinical medicine and the buzzPhrasingBehavioralisms in 'psychopathology' which from time to time may be used to denote, well, actual medical problems in the areas of psychologyStuff, but all too often has decayed into the space of the merely pathetic psyche major cancerous boil on the bottom feeders of snake oil salesmen. ) { Note, keeping with the hipster treads of total coolness I should be obliged to admit that, why yes, I does have me a dog in this fight. Since far too many times I have come home CONUS to meet some 'sorority girl' - and i use that term in the gender free context - of folks what wants to be all supportive and stuff, about how as I has me one of them thar 'defensive' like complexes. Wherein I have been compelled of mere pre-post-factualism to note the obvious - "i have something to defend." So yes, some of the pop-Psyche buzzphrase generation stuff, well, I fear is a leading cause of nausea, angst, undt ennui! Just saying! }

So, needless to say, when I was drawing the comparative analysis between the various possible methods of treating gun shot wounds, I was ever so polite as to allow for various Co-operative Alternative Methods, including my family favorite, the argument about the appropriate and applicable school of psychology which should take precedence. Not that I am going to expressly assert that there has ever been a full on holy war of true believers between say the Rogerian and Jungian Therapist Schools about the appropriate mechanisms of psychotherapy that will help the person suffering from a gun shot wound, per chance a sucking chest wound, to find the positive life experience that is the teachable moment they are constructively engaging in a synergistically positive phrame work. { should I scream NOW that the freaking word speller can actually find a correct spelling for synergistically - or would this be a good point to segue into the total abuse of the language. }

At which point, as you might imagine, I looked up from my book, and noted that EvilHM was glaring at me, armed with a spoonful of oatmeal threatening vociferously:
STOP!
STOP!
Or I will be forced to shoot you!
which clearly shifted the tenor of this discussion from the pureland buddhist pedantic, to the obligatory right-wing extremist paraOatmealist extremism of those who oppose the traditional science based medicine for their ideological compliance models. { Lysenkoism for the unInLightenedOnes what has not caught the fire yet! }

At the other end of this discussion is the scary world of those who are not quite sure how they deal with the mere existence of a scientific model of the cosmos. As if the metaphysics should have some extension set to the mere physics that will explain all of the rest of the mere hobgoblins of lesser minds.

It would seem reasonable at this point to let loose that other attack puppy of social obligation, as we address the problems of modern medicine, and those evil liberals in their ivory towers of mere modern science stuff. As so many of my friend have heard me kvetch, I was ever so lucky as to post the highest natural science exam score, based upon my religious commitment to my hope and faith that since my tutor was a key player in setting that seasons natural science exams, that I would be able to play from strength in physics and stuff like that. BUT NO! I would learn that the Godless Heathen Apostate Spawns of mindless american hating Biology Freaks were there in force to raise, well the usual essay style exam questions about showing some competence and capability in the area of stuff that is in line with the radical left wing extremist ideological deviationism of Biology.

So bottom of the ninth inning, three/two pitch time, I dig into my majikal bag of holding and dredge out my two strong cards in this space. Out comes my awareness of Manual of the Medical Officer of the Army of the United States from of course Brevet General Tripler for whom Tripler Army Hospital was named. I should of course have kept a bibliography of the combat corpmen who passed along the indigenous cultural heritage of the US Military Combat Medicine, since well, gosh, that would of course have added a level of pedantic pustules that would have made the matter, well, more in keeping with that whole radical leftwing extremist dogma about science stuff. As an aside, I must confess, also, that it was clearly a sign of the existence of god, that one of those long lonely days while shopping in Hickham AFB's Base Exchange, that I would be engaged in the culturally sensitive married male persons distance offering support system, that I found myself before the magazine rack, reading a write up in "Soldier of Fortune" that would include an appropriate bibliological addendum that covered the specific area in doubt about the cultural heritage of the treatment of combat related kinetic energy transference event sequences, pedantically known as treating gun shot wounds without all of the stuff in the modern science bag of basic medicine.

As you might imagine, while it was note worthy to be the top scoring pedant on the NatScis, the folks down in the biology department, consistent with their radical left wing extremist ideological commitments were openly opposed to my showing up in their area. Since, well, somehow using maggots to flush wounds was not high on their best practices list. Albeit none of them ever addressed the medical maxim with regard to wild turkey, in re:
One in the patient,
One in the Wound,
One in the Doctor.
but I chalk that up to their obvious Eurocentrism. Either that or their religious hope in the on going horrors of their radical left wing extremist dogma that some how modern medicine would be maintained as some sort of 'right' under their leftwing extremist system. Rather than allowing nature to take it's course, under the feeDome of the Market, and thus giving them a chance to embark upon a wide variety of opportunities as the shooting starts.

Now do not get me wrong here folks, some of my best friends shop at Whole Foods.

Or maybe the real issue here is not whether I have some sort of fetish one way or the other. Trust me, given someone who knows how to start a saline drip, and has access to O2 in a bottle, with a helo evac, and, well, a more organic holistic all encompassing back to the land approach. If it is my golden hour with a gun shot wound, let me be unambiguous here:
POP SMOKE!
GET DUSTY IN TO COVER THE LZ!
AND WE NEED A MEDIVAC STAT!
your mileage may vary, void where prohibited, and I do not mean to be culturally insensitive to your indigenous cultural heritage -- but I am willing to risk the Freaking GI trots from which ever penicillin based anti-biotic that we may proscribe to cut down the infection.

Yes, there are various anti-biotics that my physician freaks out when I explain to him the side effects, since, well, most of his patients go bat shit before then. But, well, gosh kids, I have been in places beyond the perimeter of where federal express will deliver. I know what it is like to live in the land beyond the modern medicine, where we have been obliged to reach back to sanguine tomes of the 19th century! But that was NOT about being culturally sensitive! It was not about being Organic! It was not about embracing freaking Holistic LifeStyles! It was about improvising and adapting to do the best we could with what we had on hand!

Now do not get me wrong here. I really do think that everyone should be able to spot a "kelly clamp", without having to get all bogged down in the technical IngeNerding definition of forceps because, they are using it to smoke joints, rather than using it to pull out the bullet and/or it's fragments. And yes, to be culturally sensitive, that is merely my first choice of cultural contexts! I am sure that members of the Geek Community were first introduced to K-Clamps for seating any number of transistorized componentry and were never EVER engaged in the recreational pharmaceutical industry.

At which point we may be able to raise a variety of questions about the so called western world where they have opted out of the forward march of progress, for, well, the backward march into the land before time! For our slow readers may I remind them again that being a conservative is about trying to 'conserve' something. It is not about being some sort of retro-dickhead because you wished that you could have been the war winning guy, but, like Tom DeLay, you too know what it is to be victimized because the government was giving the good billets to the darkies, gayz and girlz! so you personally feel like a persecuted minority.

What if there were a spectrum of options form the 'going galt' land of somlia, through lesser happy places, to where ever it is that you are living?

What if it was not about contrasting modern medicine and the mythological hopes about what the past would have been if it had been some other past?

What if the mere scientific method has not changed in the intervening years?

Just as the problems of a bullet wound have not changed since the introduction of 'hand held artillery'? That while, yes, the japanese were able to, as Noel Perrin's noted Giving up the gun: Japan's reversion to the sword, 1543-1879 was, well interesting, but a scary awareness that there are rejections of technology that are romantic, and, DANGEROUS!

Oh yes, for our modern readers, there is of course 1421: the year that china discovered america.... or as those of us in the actual flow of history know as the year that the chinese abandoned technology because that was the year that GOD punished China, and it's forbidden city, by sending lightening to scare the great leader of the time.

The unpleasant part here is that our christian dominionists will embrace this as more Proof that Jesus wants them to abandon technology and retreat into an American Exceptionalism of their choice, because, well, now is the time to correctly reject the technology that the Chinese Abandoned - the ocean going junk, the navigational aids, etc...

While of course, on our left wing, we can support our crystal gazing, navel lint weaving, Obama supporting, mythological hoping persons, who are into the extra special sauce....

Oh me, oh my.

What if the scary moment here is that there is a good enough excuse in denialism, that will explain the rise of teaTardianism? Just as gooder as any other abandonment of modernity.

What if the horrors of new age's assault on the federal medical system that made it a crime to sell snake oil as a solution to everything, is, well, gosh, the same as the vast monolithic right wing's assault on the underpinnings of science? Hey kids. What if we need to root around in the horrors of the sparklee poney, unicorn dancing, fuzzy wuzzy teddy bear land is as much an undermining source of all of the horror as Sarah Palin's personal support for our glorious military heroic heroes in North Korea...

What if the abandonment of mere science is problematic at more than one level?

What if it is a direct threat to liberty and freedom?
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