Learn to evaluate claims critically. Learn what is evidence, what supports a theory and what does not.

The other day I had to tell a patient they had metastatic cancer. It was suppose to be a simple operation, but the abdomen was filled with cancer. Why? Because instead of having conventional chemotherapy and radiation the patient had opted for an “alternative” cure – one that had never been tested, one that had no track record of success, but one that “sounded” logical.

The claims: natural will “boost” the immune system and the body will fight against cancer. Sounds very reasonable, and grounded in modern theory of medicine. But the patient didn’t have a science background to ask the appropriate questions such as:

• What is the result of this against conventional treatment?
• Was the study done blinded to both the patient and the care givers?

Had they asked this question the answer would have been – “no.” There was no test against conventional therapy, there was no test to determine toxicity of the regimen, there was no test to determine if there was efficacy of the regimen. It was an idea but it had never been tested in a wide range of people with a similar cancer – no, there was not a study to prove any of it. Had the patient been told that – or had the regimen been tested and found to not be effective, I would not have had to have the conversation about end-of-life care.

The result- a curable cancer was now out of control – beyond where the only measures medicine could give was empathy. It was the “Steve Jobs” effect.

Jobs, brilliant, but not trained in critical thinking. Told that his cancer could be cured by eating fruits and vegetables. When he finally realized it could not be cured by diet it was too late. Jobs lost his life at age 56 from a cancer that could have been cured.

The lack of critical thinking has caused more harm:

We have filled too many of these because of a lack of critical thinking

The infant who died in a hospital because the parents didn’t get vaccinated against Whooping Cough – thinking vaccines were bad. The infant dying of heart failure from something she should have never contracted, but did. In the pediatric ICU the doctors had to tell the parents that their beautiful daughter was dying and there was nothing to do.

Then the news of the daughter who was shot by a mother thinking she was an intruder. The evidence clearly showing that owning a gun means an 11 times higher risk of dying from gun violence than not, and no evidence showing that guns do a good job of protecting against home invasion. In fact, the evidence shows that if your house is invaded and you own guns the chances are the guns will be used against you. It sounds reasonable to own a gun and protect one’s self- but the evidence shows otherwise. In fact, Congress stopped funding gun research because it was showing what the gun lobby didn’t want America to see – that guns are killing us. But in the trauma room the trauma surgeon has to tell the mother that her daughter is dead – shot by her own hand.

The man who came into the hospital brain dead from a stroke caused by chiropractic manipulation of the neck. He thought it was better to do chiropractic treatment even though there was no proven efficacy. Now the doctors had to tell the family about saving his organs for transplant.

New Year’s Resolution for all my patients: learn to think. Learn to evaluate claims. Don’t fall for the quick internet meme.

It is harder and harder for this doctor to tell patients that they have no hope because they didn’t think, they didn’t evaluate the claims, and as a result they participated in their own death.