Wednesday, June 9, 2010

Veterinary Nonsense on the Huffington Post.

The Huffington Post is home to some of the most ridiculous and idiotic writing on human alternative medicine, and now, not to be left out, the have a veterinarian writing on "integrative" veterinary medicine. A recent post by Dr. Richard Palmquist brings veterinary integrative medicine into the world of woo that is the medical and lifestyle pages of the Huffington Post.

He begins with a statement of his scientific background;
My parents were science-based people: my mother was a dental educator and my father was a microbiologist. Many of my friends were children of members of the medical community. These people were my heroes and not one of them did "crazy, voodoo crap like acupuncture, homeopathy, herbs or reiki." These people did "modern medicine," which came from science and used the best of our knowledge to help people. I was, and still am a science guy.
Apparently he forgot to pay attention to his heroes, and in science class as well, because he proceeds to interpret anecdotes, testimonials and possibly outright fraud as scientific proof that various alternative medicine techniques actually work. He also discusses bias in a twisted way. It is true that prejudices can lead to premature judgments, but it does not mean we should accept anything based on the kind of evidence he presents in his article. being open minded is a good thing, being so open minded that you stop thinking critically, or even stop thinking at all is just as bad as any other bias that can affect our thinking. He goes on to present several anecdotes to prove his point, but to anyone who does utilize critical thinking, the flaws in these stories are fairly obvious.

The first anecdote is about a discussion he had with an alternative practitioner;
I said, "I understand you cure cancer." I knew this question would expose him for the fraud I knew him to be. He responded, "No, absolutely not. We don't cure cancer. Frankly we don't even treat cancer. What we do is support individual patients' immune systems and sometimes remarkable things happen."
This is pretty remarkable; the veterinarian admitted that he did not treat cancer, but then makes the fairly meaningless claim, common to many evidence-free treatments, of "supporting the immune system". Mark Crislip has an excellent post about supporting or boosting the immune system here .
He then proceeds to discuss cases where he thinks cancer was cured by alternative methods.
Then he presented a case complete with documentation from the top referral small animal hospital in New York. This case was a cat with a massive brain tumor diagnosed with state of the art brain imaging and found to be too severe for treatment. The cat was blind and semi-comatose on presentation to his office. After receiving dietary therapy the cat regained its sight and later had new x-rays taken only to reveal the tumor was 50 percent smaller. I had never seen anything like that before.
Top hospital or not, Dr. Palmquist knows that  an image, no matter how high-tech, of a mass is not a diagnosis of a tumor. It is a picture of something which may be a tumor, an infection, or even an artifact that only looks like a mass. Either he is leaving out many details (was the mass biopsied, was the cat treated with any other evidence-based treatments, etc.) or he is not asking the scientific questions he should be asking.
The next anecdote is another cat with a tumor;
On Monday I went to his clinic to observe him work. The first case was a terrible oral tumor that was recovering after receiving cryosurgery -- freezing the tumor to kill it. I had not seen this type of surgery for this kind of disease before and was amazed at how well the cat was doing. I also noticed the intensely honest communication and loving connection he had with both the people and then cat. My heart melted a bit.
This is another common tactic of alternative practitioners; co-opting  science based treatments and calling then alternative. Cryosurgery has been used to treat many different types of tumors and other lesions for many years. It may be true that Dr.Palmquist had not seen it used to treat oral tumors, but it really should not have been such a surprise. Cryosurgery was commonly used for many years before Dr. Plamquist's epiphany. Honest (debatable) and loving communication is also not limited to alternative practitioners. The next case also should raise some red flags, but apparently by this time Dr. Palmquist was so ready to believe anything that he fainted;
The next case was a paralyzed German shepherd dog which was treated by top specialists. The dog was carried in on a stretcher and a neurological exam showed the dog to be
non-functional. I knew after such a long time that euthanasia or hopeless surgery was the only option, but the "likable quack" began applying acupuncture needles to the dog. The dog lay there happily, and then the needles were removed at which point the patient simply got up and walked over to the owners.
Extraordinary claims require extraordinary evidence. Either Dr. Palmquist was cruelly played, or he is again using weasel words to imply more that what actually happened. If the dog was really non-functional and was "cured" so quickly using acupucture, that really would have been remarkable. Again, what does "non-functional" really mean? The story sounds amazing, but many questions need to be answered before we accept the claims made here.

Since Dr. Plamquist's conversion to integrative medicine, he has apparently published many case reports, which are really just formalized anecdotes, and are not scientific proof of much of anything, and has written a textbook on integrating alternative medicine into veterinary practice. He is apparently a proponent of the pseudoscience of homotoxicology, and is the president elect of the American Holistic Veterinary Medical Association. The kind of fuzzy thinking Dr. Palmquist has demonstrated in his post does not inspire confidence in the scientific rigor of his association.

Addendum; Steve Novella has an excellent post today demonstrating the harm that can come from honest, caring and well-meaning quackery.


Monday, June 7, 2010

Battlefield Ridge-a microcosm of Arizona nature and history

Battlefield Ridge extends north from the Mogollon Rim for about 8 miles, and ends between East Clear Creek and Bear Canyon, one of many canyons in the East Clear Creek watershed. The ridge is named for the Battle of Big Dry Wash, which happened on July 17th, 1882, and was the last battle between members of the Apache tribal groups and the U.S. Army on Arizona soil. (Most online accounts of the battle appear to repeat errors in the timing and sequence of events of the battle-the most accurate and well-referenced description is in Dan Thrapp's book; Al Sieber, Chief of Scouts which is unfortunately out of print, but is available in many libraries.) One Cavalry trooper was killed, one apache scout was killed, possibly by friendly fire, and approximately 20 "renegade" apaches were killed in the battle.
The Canyon was later dammed, forming Blue Ridge Reservoir, which serves as a water source for the mines in Globe. Ironically, exploitation of mineral deposits in places like Globe and Jerome were one of the major reasons that the Apache were being forced onto reservations and off their traditional hunting, farming, and raiding lands in the 1870's and 1880's. 

In the last century this area has been grazed, logged, and natural fires have been suppressed, resulting in a denser forest of smaller trees instead of the open, park like pine forest that covered most of the area in the 1880's. In spite of this many of the rugged canyons in the area are in fairly pristine condition, and still have most of their original flora and fauna. 

The pictures below are from the area where the battle occurred, and illustrate the traces of the battle still remaining, and the natural beauty that persists in the area to this day. (click for full sized versions)
The front side of the monument.
The back side of the monument, listing the troopers and Apache scouts present.
The only grave at the battlefield is Pvt. Joseph McLernon's.  The Apaches who died in the battle were not buried, and were left where they fell. There is no record of what happened to the Scout who was killed.
The lower end of the ridge where the Apaches made their stand now lies under the waters of Blue Ridge Reservoir, which is often this green color due to algal blooms.
The view across the side canyon. The initial army positions were here, and the Apache  group was on the ridge that is now barely visible through the trees.
This columbine, Aquilegia desertorum grows in the limestone crevices and ledges of the area

 A small bird bolted from under the rock just under this fence as I approached.
The nest, eggs, and first hatchling are hidden underneath.

Crackerbox canyon, about a mile southwest of the battlefield is named because of the empty hardtack boxes the army left here when they camped after the battle.
A cow elk or wapiti grazing on the lush growth of the creek bottom.
At least one bear has been foraging on the early growth as well.
A dead pine and a red-tailed hawk are the only sentinels now.
The bears may soon have wild strawberries to eat.