<<Disclaimer: Verify this information before applying it to your situation.>>
Re:
Date: Thu, 8 Aug 2002 09:05:51 -0700
From: Gary Brown <[log in to unmask]>
Subject: Modern Gluten Intolerance Diagnosis (aka The earth
is Flat)
<<Disclaimer: Verify this information before applying it to
your situation.>>
The discussion on this mailing list about Gluten
Intolerance diagnosis got
me thinking (which doesn't happen often, so everybody duck
:)
The earth is still very very flat, at least as far as the
medical
community's understanding of gluten intolerance goes. And
it is going to
remain remarkably flat as long as the AMA continues to be
driven by the
forces that drive it.
,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
This little rant raised some interesting questions and a
lot of misinformation.
I am an M.D. (not a gastroenterologist). With Celiac. That
went undiagnosed for a long time. Not a member of the A.M.A.
Have a close family member with cancer and understand how
frustrating being on the receiving end of
"mainstream" medical care can be. Understand that money
drives many aspects of life in the USA including or
especially medicine and pharmacology.
Having said that, I also know that there is more to
understand in medicine than any one person can hope to,
and divisions in expertise including the brave generalist
who wades into the huge pool of "all comers" to do his best
to diagnose, treat or refer appropriately. And the
specialist who focuses more and more on limites areas to
often great benefit in increased knowledge, with the
potential risk of missing some of the "big picture"
Never go NEAR a doctor who is not willing to say "I dont
know". Or "I don't know much about that".
You should however, be able to understand why or why not
your particular issues, conditon etc raises concerns that
warrant referal to someone who does know more. Keeping in
mind that every additional step costs money. YOUR money.
It certainly seems true that Celiac is an area that is in
an evolutionary phase of understanding.
Many "good" people are doing research, and practicing "real
people" medicine, for the same range of reasons that
motivate every other group: Intellectual interest, ability,
altruism, money, power, sex appeal etc etc etc. Some
doctors are better than others at integrating the latest
knowledge and science with training, judgement, compassion
etc.
For the latest information they rely on published
information in journals held to the generally high standard
of peer review.
Sure, what gets published can be influenced by money,
politics etc, but good descriptions of research methods and
results, from the lab to the individual patient, are the
background of medical practice in the 21st century. Not
perfect, but pretty good.
What does this have to do with Dr. Fine? Well, what I know
is gleaned from his website and the published papers
available from the Medical indices. He seems to hold a
respected position on the faculty of Baylor. He has
published
many useful and scientific articles in the mainstream, peer
reviewed medical literature. I don't doubt he knows a lot
about Celiac. BUT. I could find no information in the
published literature about the methodology and tested
clinical validity of the stool based antibody tests. Did I
miss them? I am prepared to be corrected. If not, does he
have some good data to support them but choses not to share
it with the rest of the medical or general community? But
charge money for his "Special" test? Why?
Yes, the history of science and medicine is full of
innovators who were scorned early, celebrated late. It is
also filled with those who made "revolutionary" claims, for
all sorts of the usual reasons in human nature, and were
not born out.
Are Dr. Fines motives "purer" or "less pure" than any other
Gastroenterologist or doctor? How can I know? Does he know
more or less? Without the published information and public
discourse with other knowlegable scientists/doctors I
really have no way to judge. Does his testing and
recommendations make YOU feel better? OK. Does that mean he
is "right" in the big picture. No. We all have to choose
what information and who's advice we base our own health
actions on. It's really, really difficult. For me and my
family even with good medical (and other scientific)
background, even more so for those without.
I personally am wary of any one Guru (a great Guru told me
this), or idea or "secret special no one else knows"
approach.
Doesn't mean they are wrong, just that we still have to
ask, analize, weigh, compare. Sometimes jumping off the
cliff of
uncertain or alternative or risky approaches might seem
justified, as in an immediately life threatening illness
that seems to have no conventional or validated approach.
Other times (and personal philosphies) we might be more
patient.
Good luck to all of us!
Colin Ramirez M.D.
*Support summarization of posts, reply to the SENDER not the CELIAC List*
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