Sunday, November 23, 2008

The False Choice: Magic - Or Nothing At All

One of the jokes about Barack Obama is that he's the "magic negro". There's a strain within a subset of white culture that insists on seeing blacks as so supremely different from boring old white people that they go overboard and start imagining that we've got some kind of super intelligence, special insight into life, or even the power to heal. If you're a black guy with an interest in finally completing the multi-generational trek from Africa to the modern world - and then being allowed to forget the unfortunate trip ever had to be made - all this white bread mau-mauing can be supremely annoying.

But not as annoying as the rage I've faced when I've (even gently) insisted people knock it off. (As disappointed as I am that Obama let this "magic" nonsense go on until after he won the election, and only then started trying to lower expectations, I understand why he'd be reluctant to do so:) People have turned vicious when I've attempted to bust the bubble of delusion they try to thrust on me as a black man.

In France, particularly, I was always a let-down because almost everyone I encountered either infused me with incredible abilities or wanted to pity me as someone who just emerged from the jungle. (Actual Africans are despised as pests, on the other hand, while Americans indians also suffer the degrading fate of being anything other than merely another member of the human family.) The message I received from the French was clear: play into a lie - any lie they've decided to believe - or else.

Now don't get me wrong: if I went along with the delusional game the rewards were great. The French would open their homes to me, offer me the best of their food, and even make it clear their women were available if I so desired. (It became common for me to see American blacks, who looked and behaved like Flava Flav, with more than one European woman on their arms.) I got it loud-and-clear: As long as I'd go along with their expectations, life was fine.

The problem was that I wasn't allowed to be a myself - or, more importantly, even an adult human being. The entire charade was a trap. Eventually, they'd be telling me where I could go, and who I could associate with; what, when, and how I had to eat - essentially, every decision dictated by them - all for my own good, of course. Whether or not I thought any of it was good for me was beside the point. The French had their delusions and, damn it, I was supposed to encourage them. And I am still expected to.

Yes, as some of you can imagine, this post is going straight to my gullible French ex-wife, Karine Anne Brunck, and her murderous beau, "Dr." Robert Wohlfahrt. It's even going after his "patients" who are insisting - from all the way around the world - that I go along with the lie that Robert Wohlfahrt is a kind and sensitive "healer" after he's done me, and his profession, many terrible and grave disservices.

But, just like with the French lie of a choice between being a "magic" or "primitive" negro that they tried to thrust upon me, I will not go along: "Dr." Robert Wohlfahrt is a killer, a liar, and a charlatan - and I knew it from the first moment I discovered his game ("Homeopathy") or heard his name.

Unlike the French, who claim to have abandoned much of religious superstition, only to have replaced it with (or continued to believe in) pagan beliefs, I am an atheist. I have no spiritual beliefs what-so-ever. I see their old cathedrals as temples to a past order, and their association with NewAge beliefs (and "alternative" medicine) as relics of a bigger, but even more ancient, set of lies.

So, I think, it's time for France to grow up, abandon their superstitions, and join the modern world. If "Dr." Robert Wohlfahrt must be sacrificed on the alter of that transition, then I say, "so be it". He knew what he was doing when he violated my life - and my wife - as well as his oath to medical ethics.

Robert Wohlfahrt (it's about time we abandoned the title "doctor", don't you think?) despite he and Karine's claims to want to "save the planet", simply didn't care to see me - after 20 years of marriage - as a human being with feelings worth "saving". This was a major mistake.

They clearly saw me, both correctly and incorrectly, as "different" - but (as a black American) also more primitive and lesser - than they. In doing so, they didn't count on my intelligence, and determination, and the fact that, between the three of us, it is I who could turn out to be the true "modern" figure in this mess of mixed-up medicine and morals.

Despite my limited education, and all Wohlfahrt's medical training, Robert Wohlfahrt is nothing more than a witch doctor to me - and, since Karine, too, considered herself a "healer" (with absolutely no medical training) though her opinion may vary - I regard she, and Robert Wohlfahrt, as attempting to be no more than that.

And so do others in the medical profession:

"...It has to do with the differences between some cultures and our own: the fallacy is that there are “similar inclinations.” There is a vast difference between the traditional, deeply held opinions of a primitive tribesman and his witch doctor, on the one hand, and the addled opinions of a born, raised, and (partially) educated American or European or Australian patient and his snake oil peddling quack on the other. Those in our culture, with occasional exceptions, were not brought up to believe in [Complimentary Alternative Medicine].

Many quacks are themselves physicians with no acceptable excuse, who until recently were kept in check by strong professional and governmental pressures, only to have found themselves reborn in a new “golden age of quackery.” Quacks who are not physicians have also been kept in check, until recently, by governmental pressures. Their newfound endorsement by governmental edict is no more justified than would be a similar endorsement of tribal witch doctors.

My major objection, to 'implausible claims being promoted, tacitly or otherwise, by medical schools and government' and by physicians. Patients are not the problem; they are, if you’ll excuse the drama, the victims. Even seemingly benign practices, if implausible, can be harmful ('first, do no harm'), particularly when promoted by someone who should know better,...there is the unnecessary expense, a patient later feeling betrayed by her physician when the treatment doesn’t work or the 'placebo effect' wears off and she realizes that it was only a 'pretend medicine' all along, other patients or physicians concluding that the treatments have validity (and possibly being convinced to forgo rational treatment), people in general losing confidence in modern medicine when it appears that many physicians can’t distinguish between the rational and the bogus, wasted research funds, human subjects unnecessarily duped and endangered, a befuddled media, a befuddled public, befuddled leglislators endorsing quacks to a befuddled public, and more.

Yes, it is true that THIS patient needs help, but if physicians held exclusively to that ethic they wouldn’t have to concern themselves with antibiotic resistance, universal immunizations, judicious use of expensive but very low yield tests that are physically harmless and paid for with pooled money, or other cost-containment issues that don’t immediately affect THIS patient, would they? It’s true that there are many examples where ethical absolutes don’t seem to apply very well.

...Every pharmacy in Europe that advertises 'Homeopathie' is committing fraud, plain and simple. If physicians were more attentive to science and ethics and to explaining things to patients, politicians, and the media, more people would know that. The alternatives to homeopathy for minor or self-limiting complaints, moreover, need not be “NSAIDs or antibiotics or antidepressants” unless there is a good reason for one of them. The alternative is to explain to the patient that the complaint is minor or self-limiting!

Why should honesty and integrity be so difficult?  That some modern physicians prescribe potent drugs solely for placebo effects (and to get patients out of their offices) is an indictment of that practice, not an argument for [Complimentary Alternative Medicine]. There are, moreover, plenty of rational, nonpharmacological treatments for all manner of minor or self-limiting complaints (and even for not so self-limiting complaints, such as chronic pain), e.g., gargling with hot water or sipping hot tea, time, avoiding environmental allergens, smoking cessation, weight loss, ice packs or heat packs, rest, exercise, massage (to make muscles feel better, not to 'remove toxins'), pain management, physical therapy, eating more fibre, 'sleep hygiene,' and many more.

...I certainly don’t mind if 'people feel better for taking a multivitamin or an innocuous herb' (if that were the extent of [Complimentary Alternative Medicine] we’d hardly be wasting our time here). I just don’t think physicians should make false claims.

[This] also brings psychotherapy to mind. It need not be introduced in an unjustified or insulting way, i.e., by implying that the patient’s symptoms are 'all in her head' or are 'functional' or whatever. Rather, the honest physician will admit to not being able to explain the symptoms, but acknowledge that they must be distressing and suggest that it might be helpful to discuss how they impinge on the patient’s life and how she might better cope with them. 

There are plenty of modern physicians whose patients are not disposed to look elsewhere, even if those patients have 'nonspecific tiredness and unhappiness' and even if those physicians don’t suggest [NewAge beliefs]. Many patients, perhaps most, expect honesty and integrity, and have a pretty good sense of when they see it and when they don’t."

In Robert Wohlfahrt, I see nothing of the kind. As I have said, he is a liar, a quack, and a murderer. That last very-long quote was from Dr. Kimball Atwood of, a website set up to warn people about quacks, like Robert Wohlfahrt, who assume they have no choice but to lie to their patients by suggesting alternative treatments. Dr. Atwood continues:

"I have not assumed, nor is the assumption inherent in ethical objections to physicians promoting [Complimentary Alternative Medicine], that 'conventional medicine has adequate answers to all health problems.' I reject,...the false [choice] that for each health problem there is either a proven treatment or there is [Complimentary Alternative Medicine]. 

...The only 'value' of almost all [Complimentary Alternative Medicine] treatments is in their 'placebo effects.' But if a physician’s quest to elicit a placebo effect from an implausible treatment means pretending that the treatment has some other effect, specific to the patient’s problem, then that is a lie. So far, I’ve seen nothing to justify such a lie.

There is a potential placebo effect involved in every patient-practitioner interaction, and it needn’t require [NewAge beliefs]. The most important elements are that the practitioner be attentive and appear to give a damn. Many patients will experience dramatic improvements in symptoms just by finding out that whatever is causing them isn’t cancer or some other serious illness—which reflects an underappreciated reality about the goal of a diagnostic 'workup': not necessarily to determine what something is, but always to determine what it isn’t. The refusal of some physicians and patients to accept that truth is, in my opinion, an important basis for a [Complimentary Alternative Medicine] subset, 'fad diagnoses',....

As a patient, I have experienced two memorable examples of what I think of as 'placebo effects.' The first occurred at the age of 18 when, plagued by adolescent angst, I visited a psychiatrist exactly once who told me, 'you’re not crazy and you’re not going to go crazy.' I remained an adolescent for some time, but I sure felt a hell of a lot better. The second occurred many years later and was heralded not by a conversation, but by a diagnostic test: after a couple of months of excruciating neck pain, I had a magnetic resonance imaging (MRI) study that showed that my cervical spine was normal. As I read the report the pain abated, never to return to its previous degree of severity."

The 'placebo effect' is Robert Wohlfahrt's stock and trade. It is how he makes his living. But, just like the French belief that I must be more or less of a human being - in their eyes - to exist as a whole person in my own, Robert Wohlfahrt makes his living (and derives his sense of pride) through perpetuating a massive lie.

And just like the choice forced upon me by the French - between being a "magic negro" or some kind of a modern primitive - it is a nasty, degrading, and despicable lie this particular American (not an "African-American") refuses, for even a minute, to stand for or abide.

No comments:

Post a Comment