The Peoples Anecdotes

The Peoples Anecdotes

I used to read almost exclusively history, and when I hear the term "Peoples" I think of ideologically driven organizations whose purpose is to enforce a status quo that is divorced from reality. Like Peoples Courts of the last century. Peoples in that context has as much meaning as 'democratic' and 'republic' in the title of totalitarian government. The Peoples Republic of China, as an example, is neither.

We have a saying in science-based medicine: the plural of anecdote is anecdotes not data. Humans are prone to a tremendous number of fallacies and biases that make it easy to fool ourselves into believing that something exists when in fact it does not. It is often difficult to recognize just how flawed reasoning can be. It is why we rely on science as the best method for attempting to minimize bias.

The most egregious example of failing to recognize bias and logical fallacies and elevating anecdote above all else is perhaps the People Pharmacy

Week after week they present anecdotes of bizarro home remedies as if they are a reasonable  intervention. I recognize the power of anecdote. It rules. One anecdote will usually trump a fancy-pants pointy-headed scientific study for most people. Of course, that neither validates the anecdotes nor invalidates the study. People just prefer to believe a good story.

A reader of the Peoples Pharmacy wrote in to note that two of the remedies were bogus. Yellow mustard could not relieve leg cramps in less than two minutes the relief was too rapid,  faster than human physiology. She also noted that a bar of soap at the foot of bed could in no way relieve leg cramps.  

Both criticisms seem a reasonable, reality and science-based analysis of the potential efficacy of mustard and a bar of soap for cramps. She called it junk science, but I would just call it junk anecdotes.

The Peoples Pharmacy begged to differ, in a response that is as far from a science-based medicine approach as is possible.

First they suggest that despite a prior plausibility that would suggest neither mustard nor soap should have any effect on cramps,

we have heard from hundreds of people who have done their own experiments.

so it must be so.

The obviously do not subscribe to the idea that the three most unreliable words in medicine are "in my experience.'

They continue

"Even though we can't explain why mustard or soap can be helpful against cramps in such a short amount of time does not mean these remedies are bogus."

Mustard. Well maybe. The could be something in mustard that could decrease cramps. Extremely unlikely, but possible, and there is still the faster than onset of action. But soap? Seriously? A bar of soap at the foot of the bed for cramps isn't bogus? They operate in a different realty than me.  They note

The mechanism of action of many prescription drugs is also unknown.

I tried to think of some medications that fit the description. Psychiatric drugs to some extent, but for the most part we know the mechanism of most drugs. I went looking for a number, and I couldn't find one. I ran though a list in my mind of routine medications and I was struck by how many of the medications we give are identified by they mechanism. Patient is on a beta blocker or an H2 blocker etc.  I would bet there is a reasonable mechanism for the vast majority of prescription drugs.

And even if we do not know the mechanism of action of, say an antipsychotic, doesn't mean we can't, on general principles of reality, recognize that a bar of soap for cramps is bat-s**t crazy.  Well, it would be bat-s**t crazy for a pharmacist to suggest it, for a patient?  Probably just confirmation bias.

They then note that soap and mustard are, unlike prescription drugs safe and inexpensive as if somehow that validates the efficacy of soap. In the bed. For cramps.  Every time I write that I think, it's a pharmacist suggesting it. And an anthropologist.

And they note that there is no FDA medications for cramps. So that somehow validates the use of soap and mustard.  There is no approved therapy, so lets use soap. At the foot the bed.

It amazes me that one of the Peoples Pharmacists can be a

Fellow in Pharmaceutical Sciences of the American Association for the Advancement of Science (AAAS) for "exceptional contribution to the communication of the rational use of pharmaceutical products and an understanding of health issues to the public"

Sigh.

One of the Peoples Pharmacists is also an advisor to Dr. Oz, so we have an explanation for the source evidence of that show.

It always amazes me how absolute nonsense can be included in the otherwise reasonable medical advice about medications on the site.

The comments are particularly interesting. People get cramps, take mustard and the cramps go away in 5 minutes. See? The mustard works.

I get leg and other cramps all the time. I take nothing and do nothing but stretch the cramped muscle and they always go away in 3–5 minutes. It is a self limited process.

And they sell a bar of bed soap on their site for $8.95 for cramps, about 4 to 8 times a bar of soap on Amazon. Shouldn't they have a conflict of interest disclaimer as well? 

"Integrative Medicine" has no place in Australian ...
Points of Interest 08/27/2015

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