Question Medical Authority

By Bill Drake

Doctors wear white coats for the same reason that judges wear black robes, cops wear badges and uniforms, the Pope wears funny hats, kings and queens wear crowns, corporate zombies wear suits, and soldiers wear ribbons and medals — they all want you to see that they have authority, and you don’t. This means, among other things, that you are supposed to do what they say, and not ask questions.

As a person using marijuana for medical purposes, you have no doubt found that many if not most of the doctors you’ve come across are like this.

It is an extremely rare doctor who welcomes questions from patients, unless those questions are asking for advice — certainly questions that challenge advice are not welcome.

However, in my experience, that is exactly what you have to do every step of the way if you are going to actually be healed of whatever disease or ailment you are suffering from, because if you don’t, the odds of a successful out-come drop dramatically.

Doctors are busy people and for the most part stopped keeping up with research in their field the moment they left medical school, with the exception of what they gath-er attending seminars at medical conventions and from the pharmaceutical industry reps who bring them “the latest research,” which incidentally involves giving their patients the latest drug their company is pushing. They certainly don’t have time to study research that is outside their field — a gastroenterologist generally has no idea what the latest research in endocrinology shows, and vice versa. If you go to a cardiologist to complain about pains in your chest, sure enough you’ll get that heart of yours tested, but the heart doc will probably never consider the possibility that diaphragm spasms caused by SIBO (small intestinal bacterial overgrowth) are pulling on your heart, or that you have a massive ulcer caused by Helicobacter pylori infection in your stomach.

Likewise, if you go to a gastroenterologist complaining of certain kinds of gut problems, you’ll no doubt be test-ed for celiac disease and Crohn’s, but there’s almost no chance that the gastro guy will order a panel of thyroid tests to see if you have Hashimoto’s thyroiditis caused by an immune response to gluten in your diet, which causes a parallel auto-immune attack on your thyroid. (Wheat gluten and certain tissues in the thyroid have identical molecular structures, so if you have the genetic predisposition to gluten intolerance, the immune system considers them the same foreign protein and attacks both.) Even if you have been tested for gluten intoler-ance by the usual blood test, that’s no guarantee that your immune system agrees with the test results. Equally unfortunately, your thyroid can be under immune sys-tem attack and you can have perfectly normal TSH and T4 test results — Hashimoto’s only shows up when you are tested for thyroid antibodies, which most docs sim-ply won’t do without a lot of arm-twisting, for some rea-son known only to them. If you have a lot of gut symp-toms that don’t yield to conventional diagnosis, this might be a possibility for you to explore.

The point is that while doctors are often very good at diagnosing and treating the 80 percent or so of patients whose problems in fact do lie within the boundaries of their specialty, almost none of them will ever consider stepping outside that specialized area of knowledge to look for linkages. Now, supposedly, that’s where the generalists like GPs and internal medicine docs come in — they are supposed to have an overview that gives them a more holistic perspective on you and your health issues. However, these docs suffer from the same lack of time (and personal initiative) to stay on top of all rele-vant research in all fields so that they can in fact do their job of finding linkages between sets of symptoms that fall under different medical specialties and then send you to the appropriate practitioners in those specialties.

Most doctors would like for you to get better, and they would like to get credit for it, but even more, they want to get paid, whether they help you or not, and if they try everything they know how to do and you still don’t get better, then a subtle shift takes place, and they begin sending you semi-concealed but obvious go-away mes-sages. You become known as a difficult patient. You are told, “There’s nothing more we can do for you.” Far too many doctors like to think of themselves as people with a magic kiss that can make the boo-boo go away, and when their magic doesn’t work, it somehow becomes your fault. That’s just human nature at work — but you wind up on the short end of that particular stick.

This is where you come in. Only you have a really press-ing reason to spend the time and energy needed to thor-oughly research your health issues — you want to get better! However, before you even start doing your own research, there are a couple of things that you must do. The first is to find a GP or internal medicine doctor who is a good listener and who doesn’t think he knows every-thing. Next, you have to understand what kind of infor-mation this doctor (any doctor really) will give credibil-ity to, and why. Finally, you have to be able to research within the framework of that kind of information and, as you begin to discover what may be wrong with you, you have to know how to approach the doctor with that information.

Let’s take this one step at a time. If you don’t already know a doc who listens and doesn’t think he already knows all there is to know, you are going to have to net-work with your friends and family until you find some-one who knows such a doctor, and then you have to get into his practice. Fortunately, there are plenty of good docs out there — you just have to sort them out until you find the one who is right for you.

Then you have to get on the Internet and find out every-thing you can about your symptoms. We all know that the Internet is full of as much bad information as good, and it’s a matter of using your judgment. In general, I would say that Web sites that are pushing something are not good sources of information. Discussion groups and moderated forums tend to be much more productive. Finding people who are dealing with the same set of issues and symptoms as you are can be quite helpful. They can help you connect your symptoms with a set of possible diagnoses — but this isn’t information you want to print out and take to your doctor. It’s just the first of two key steps — identifying what might be the cause or causes of your problems.

The next and most critical step is to understand that doctors only accept one kind of medical/scientific infor-mation — the kind that comes from peer-reviewed articles in recognized medical journals. This is actually a good thing, because it sets a high standard for the authenticity of the information. And here’s where things get really cool!

The National Institutes of Health, an agency of the US government, publishes an online database containing abstracts of over 15 million peer-reviewed articles from recognized medical journals around the world — not just from the US. There are articles from peer-reviewed medical journals from dozens of countries with advanced medical research facilities. The database goes back as far as the 1960s and comes all the way forward to abstracts of articles that haven’t yet been published. Even better, the articles all cite the names of the researchers who did the work and are publishing it, and there are almost always direct e-mail links to the researchers.

So once you’ve done your background research in forums and discussion groups online, you then move to the NIH database and begin using your symptoms, as well as any diagnosis that you think might apply, as key-words to troll for medical journal articles where your symptoms are discussed. This can be time consuming, and you have to be able to understand some pretty high-level scientific/medical language to make sense of what is being written, but don’t let that discourage you, because these abstracts are almost always written with good, clear language, if not exactly layman’s language, and with a little effort you’ll be able to penetrate the lan-guage. It also helps (a lot) if you understand elementary statistics, because most of these abstracts discuss their findings using statistical language in the body of the abstract. But even if you don’t understand statistics very well, or at all, don’t despair, because there is always a short paragraph at the end of the abstract, called Results or Conclusions or Findings, in which everything is sum-marized in reasonably plain language.

I won’t keep you waiting any longer for the address of this database, which is

Once you log on, you’ll see a simple search box at the top of the page, where you can enter your search terms and go. On the home page, you also see a lot of other specialized search options, but stick with the simple search box at the top at first. Once you get into the data-base, you’ll see that the articles are generally arranged with the most recent on top. When you click on an arti-cle that looks relevant, you’ll get the abstract of that arti-cle but you’ll also get a box on the right-hand side of the screen that suggests related articles you may want to investigate. As you proceed with your research, keep a Word document open on your desktop and just drag to select the abstract and its author data, then copy and paste this into your Word doc, which becomes your file of possibly relevant information.

My suggestion would be to spend a little more time once you’ve collected your abstracts and go through them, putting the most relevant at the top of the document, saving your doctor the time and trouble of sorting through the informa-tion himself. You are a lot more likely to get even a good, attentive doc’s attention if you hand him a single sheet with a couple of really juicy abstracts rather than a folder full of stuff to read. (And don’t forget, the contact e-mail addresses for the researchers are almost always at the top of the abstract, so your doc can be in touch with the authors if he wants more detailed information.) Once he has read what you have given him, and you get his opinion on whether or not this might be relevant to what you’re dealing with, then is the time to say, “Oh, by the way, here are some more articles I thought were relevant — I just didn’t want to overwhelm you with all this before we had a chance to look at the ones I thought were most interesting.”

Let me end this foray into how to research your own health issues and find a doctor who is willing to consid-er information that lies outside his own field of knowl-edge with a short story on how I came to understand this process.

My wife was diagnosed several years back with a condi-tion called Barrett’s esophagus. There was a pre-cancer-ous lesion in her esophagus where it joins the stomach. The Barrett’s was caused by reflux, which was in turn the result of SIBO (small intestine bacterial overgrowth), which in turn had been caused by an overdose of the wrong kind of a powerful antibiotic for an operation she had, which destroyed the good bacteria in her upper GI tract, allowing pathogenic bacteria to move upward from her colon, where they are normally kept in check by the good bugs in the upper reaches of the gut. The good news, the gastroenterologist told us, is that the lesion is in its very early stages. The bad news, he told us, is that Barrett’s invariably progresses into cancer, and at some point we were going to have to take extreme measures, including surgery and radiation.

Aren’t there any treatments for Barrett’s in this early stage, we asked. No, he said solemnly, we have no research that gives us any treatment modalities. (Doctors just love to use words like modalities.) Now, I have since that time learned that when a doctor uses the word we, he means the entire medical profession, and that is supposed to end the discussion right there, because if the entire profession doesn’t have a cure, then none exists — right?

Neither my wife nor I take that kind of bullshit for an answer, so we paid the guy’s bill and left. Having been through this before, the first thing we did was to log on to PubMed and start looking. At first, we kept running into dead ends, but one thing about research is that you simply have to keep trying — shuffle your keywords around, rephrase, come up with new keywords, etc. To keep this story short, we finally found a research paper presented in France by a US gastroenterologist whose research was not accepted by his peers in the US but which had attracted the attention of the European medical community.

His treatment method was simple and noninvasive, and it used very inexpensive medications, and it worked — over 97 percent of his female Barrett’s patients had experienced complete remission within three years of beginning treatment, and most had been successful within one year. In retrospect, it’s easy to see why his work was rejected by the US gastroenterology establishment — it was simple, inexpensive, and worked without any of their fancy technology and high-priced drugs. Can’t have that, now can we? We tracked this doctor down (he had retired, but a nurse in his former clinic put us in touch with him), and he agreed to call our doctor and discuss his treatment with her.

They spent an hour on the phone and our doc came back to us and said that his research was impeccable and that we should begin immediately. We did, and it worked. End of story. I wish that I could promise that every person’s medical dilemma can be cured as simply as this one ultimately was, but of course I can’t. What I can promise is that if you don’t confront and challenge medical authority, and if you don’t understand how to do it effectively, then your chances of being cured go way, way down.

Self-treating with marijuana is an excellent choice for some people with some health issues, but it is unlikely to be the single overall answer, especially when you are dealing with serious health issues, so at some point you are going to have to take advantage of the best that conventional medicine also has to offer. When you do, if you are well prepared with the facts in a form that a doctor who is willing to listen can deal with, your chances of success are far increased. It really is that simple.