I’m reading a charming book this week called “The Book of English Magic.” The adjective charming is apt on several levels, for the book not only has a seductively pleasing tone, but it also frequently talks about “charmers,” including magician-healers of the past who treated their patients with mantras like abracadabra (a Roman charm against disease) and amulets, such as a toad’s leg worn in a cloth bag around the neck.
Ah, if only we could cure serious illness with such simple magic.
Of course, that’s the appeal of so much of the mumbo-jumbo behind many alternative treatments popular today, like homeopathy and Reiki (and Suzanne Somers’ mistletoe extract): The treatments make no sense scientifically, but they’re explained in simple and, yes, soothingly magical language.
How much easier it is to understand Reiki’s human energy fields than, say, neuroscience’s complex molecular mechanisms and neural pathways — particularly when most of us have received a poor scientific education. (A molecule, a neuron, a synapse, a protein receptor — what are those?)
Scientific illiteracy is a major reason for the continued thriving of alternative treatments that have been repeatedly shown to have absolutely no medical benefit (beyond, perhaps, the placebo effect).
But alternative treatments have another appeal: Their “prescriptions” are easy to follow. Wear a crystal. Get attuned. Drink ginseng tea. Burn some lavender incense.
Adhering to conventional medicine, on the other hand, can be much more complicated, particularly when the treatment is for a chronic disease — and particularly when the instructions are written (or given orally) in such complicated, jargon-heavy language.
Who wouldn’t prefer the simplicity of magic?
Our health illiteracy
Those were my thoughts as I read Washington Post reporter Sandra Boodman’s article Monday (published jointly with Kaiser Health News) about “Americans’ alarmingly low levels of health literacy — the ability to obtain, understand and use health information.”
Writes Boodman:
A 2006 study by the U.S. Department of Education found that 36 percent of adults have only basic or below-basic skills for dealing with health material. This means that 90 million Americans can understand discharge instructions written only at a fifth-grade level or lower. About 52 percent had intermediate skills: They could figure out what time a medication should be taken if the label says “take two hours after eating,” while the remaining 12 percent were deemed proficient because they could search a complex document and find the information necessary to define a medical term.
And before you make the smug assumption that you’re included in that top 12 percent, take note, as Boodman points out, that “even highly educated patients are affected, particularly if they’re stressed or sick.”
A patient-education manager gave Boodman the example “of former New York mayor Rudolph Guiliani, who thought he was cancer-free when his doctor told him several years ago that his prostate biopsy was ‘positive.’ Actually, a positive biopsy indicates the presence of cancer.”
Boodman relates several other examples of patients who misunderstood their doctors’ instructions, sometimes with potentially life-threatening consequences, as in this case:
A patient who had been prescribed daily insulin shots to control his diabetes diligently practiced injecting the drug into an orange while in the hospital. It was only after he was readmitted with dangerously high blood sugar readings that doctors discovered he was injecting the insulin into an orange, then eating it.
A need for plainer language
Hospitals, health plans — and public health officials — are now actively trying to improve health-literacy skills with better written health materials. There are huge amounts of money as well as lives at stake. It’s estimated, reports Boodman, that poor health literacy costs the U.S. economy as much as $238 billion annually.
One obstacle to improving our health literacy, a heart surgeon tells Boodman, is the “medicalese” language doctors too often use with patients. “When we say ‘diet,’ we mean ‘food,’ but patients think we mean going on a diet,” said the surgeon. “And when we say ‘exercise,’ we may mean ‘walking,’ but patients think we mean ‘going to the gym.’ At every step there’s a potential for misunderstanding.”
There’s also the potential, I would add, that by not taking the time to educate patients in plain language about their illnesses and treatments, conventional medicine runs the risk of driving some seriously ill patients into the less complicated (and thus less frightening to the patient) “magical” realm of alternative therapies.
And that’s definitely not a charming outcome.
You can read Boodman’s article here.
And does not an Academic Health Center, such as the one at the University of Minnesota, have some responsibilities in this area?
Apparently not. I wrote an article about homeopathy at the U for the Chronicle of Higher Education that was responded to by both the present and former deans of the U of M medical school.
Their pitiful response did not even MENTION the word homeopathy.
Those interested might find this matter amusing, except that the consequences are so serious.
More Denial at the University of Minnesota Academic Health Center/Medical School over Homeopathy Link: http://bit.ly/gfW8tQ
“This is a pathetic response from the present and former deans of the University of Minnesota Medical School. Presumably they have taken chemistry courses at some point and are both aware of Avogadro’s number. There is no medicine in homeopathic medicine, gentleman. And this was a pitiful and evasive answer to my original question: Why would an Academic Health Center support homeopathy?”
Health practitioners could learn something from the practice of web usability, as it’s promoted by scientists like Jakob Nielsen.
The key thing in usability testing is to watch and see what real people do while using a website, or in this case, with medical information. The examples above of Rudy Giuliani and the diabetic with the orange are the types of things that, analogously, are found while watching people use websites.
Excellent points! And for the elderly, communication, guidance and knowledge can make a difference between a longer life with some degree of quality and losing their independence
And yet the medical/health care community freely and commonly EXPLOITS those proclivities to magical thinking so common in the American Public.
One need look no further than the constant barrage of commercials for pharmaceutical products featured on television and in magazines: half of them invent new conditions or syndromes which their products (not coincidentally their newest, most expensive products) will perfectly relieve.
All of these commercials make their products out to work “like magic” to relieve your symptoms (even though the vast majority of the products they’re advertising are no better than existing, far cheaper, alternatives).
When people don’t understand the inner workings of their own bodies and psyches, let alone the care and protection of the same (such health information being nonexistent in most of our schools) the effects of well-practiced medicine seem so incomprehensible and therefore, so magical as to allow unethical companies and practitioners to profit very massively while peddling little more than snake oil (to both doctors AND their patients).
Furthermore, how often has the most “common wisdom” of the medical field, wisdom practiced for decades, been revealed to be useless if not completely wrong over the past few years?
As the old joke goes, “Ten years down the road we’ll be hearing about ‘Oatmeal, the silent killer.'”
When the “common” medical wisdom is based as much on fads promoted by pharmaceutical companies, chemical companies, or food producers, as on any verifiable evidence, and such “common wisdom” is even massively promoted by trusted advocacy organizations such as the American Heart Association and the American Cancer Society, and what was touted as absolute truth becomes complete falsehood, almost overnight, is it any wonder that patients think there may be better sources of information and healing than the constantly-shifting, contradictory (and often very expensive) “common wisdom” of medical professionals, pharmaceutical companies, and medical products companies?
Perhaps if we taught our students how their bodies actually work (in health classes), what types of basic exercise routines they could use to stay in good physical condition for the rest of their lives (in physical education classes, which generally do not touch that subject), and how to care for their psyches, including what to expect when they go through grief (which adolescents, in moving in and out of their first romantic relationship, tend to do more than at any other time in their lives), how to deal with psychological stress, how to heal the wounds inflicted on them by the painful experiences they may have already experienced, and how to support others as they seek to do the same, we would likely pull the rug out from under a lot of the snake oil being peddled in the name of “medical care” in favor of allowing the average person to make far-better-focused, far-more-rational decisions.
For the average student, how to deal with their OWN personal history and their own genetic makeup, and thus, how best to maintain their own physical, emotional, and psychological health are far MORE important than dealing with the history of their state or nation (which are also VERY important). Why don’t we teach them how to do so?
We could produce the healthiest generations American has ever seen while, at the same time, saving huge amounts of medical care cost.
If a candidate for President were to run on a promise to end pharmaceutical advertising on TV, radio and print, do you think s/he might win in a landslide?