The Air at the Top of the Bottle

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Medicine and Methodology

May 22nd, 2009 · No Comments

[Here is, approximately, the outline Dr. Mamie Caton and I followed for our bit in our Medi-Vaudeville event.  I prepared it to allow interaction with Mamie (who was too busy to write anything herself) and with the audience.  And I’ll pursue it on another page, to keep the home page tidy.]

(Posted by Doug Skinner)

I began with a 1907 song by Huntington & Helf, “I’m Tying the Leaves So They Won’t Come Down”: a boy, told that his playmate is sick, and will die when the leaves fall, ties down the leaves.  She recovers, and he credits his treatment: an example of methodology gone awry.

A brief refresher on scientific method: it combines observation and analysis.  Observation can be uncontrolled (field work) or controlled (lab work).  Analysis can use comparison, speculation, and inference (induction and deduction).

Experimentation is a form of controlled observation: formulate a testable statement; check it with peer review and reproducible results.

In an ideal world, the leaf-tying treatment would be corrected.  But the method has pitfalls.

Problems with observation: subjectivity, limited senses.  Evolution provides enough accuracy for survival, not always for objectivity.

Problems with analysis: again, we’re deeply subjective.  Organization of material affects interpretation: Korzybski’s “The map is not the territory.”  The Animal Kingdom is not really a tree, for example.

Logic can be inconveniently abstract: The Law of Identity (A=A) is impeccable; application problematic.  If A = a cup, the cup can be crushed in a second, changing its properties.  I am I, but was different 50 years ago.  We must be precise in defining “A” and “=”.

Instinctive behavior unavoidable, affects method.  A test of the leaf-tying treatment (or “preventive decidual retention,” as it will be redubbed for more gravitas) may be compromised by: preservation (income depends on it), social adaptability (stigma if you question it), defense of territory (reputation based on it), hierarchical patterning (prestige of it), sexual display (questioning it makes one more/less attractive).

Applying method to human body difficult, due to variables: sex, age, race, diet, genetic diversity, other conditions (Mamie called upon for examples).

Difficult to quantify pain relief; to devise double blind test of surgical procedure, etc.

Patients lie about: drug and alcohol use, other conditions, sexual practices, compliance with treatment.  All risky behavior also an ethical/social issue, colors responses.  (Again, Mamie consulted for examples).

Only about 20% of mainstream medicine “evidence-based.”

“Alternative” not a definition, but a term of exclusion.  Mainstream medicine now accepts many “alternative” treatments, especially for pain relief, especially if otherwise harmless.  Mamie offered capsule views on: chiropractic, acupuncture, herbalism, hypnotism, meditation, prayer, homeopathy.

One possible conclusion: both mainstream and alternative practices are tough to test; classification as one or the other is more social than scientific.  


Tags: Belief Systems · Education · Politics · Symbols

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