From: ((Steven B. Harris))
Subject: RE: Royal Rife and cure for cancer
Date: 19 Jun 1995

In <9JUN95.10541105@skyfox.usask.ca> portert@skyfox.usask.ca writes:


>Rich,
>
>I appreciate your response. I would like to add a few things that may
>clarify my position. First, there are several M.D.'s I know for whom I
>have great respect. The MD's I commented on did exactly what I said they
>did. There is not a misunderstanding on my part. I call them witch
>doctors in the sense that they (really only a couple) misdirect
>information. As a further example, my daughter has eczema. This MD told
>me she had epidermoid eczematous. I asked if this was eczema, he then
>gave me the specific latin name for the specific variety that she has. I
>fully believe what he did was intentional. I know that his methods are
>not representative. Circumstances prevent me from using another MD.

I think it probable that you still didn't communicate.  "Eczema" is not
a disease, but a general condition of the skin (which could be caused
by dozens of things).  It is no more pathologically meaningful to say
that your daughter has "eczema" than it is to say she has "anemia" or
"jaundice" or "sore throat".  Your doctor may have been trying to tell
you what disease she does have, but not all diseases HAVE common English
names.  Some of them, like some insects, only HAVE Latin names.  What is
a physician to do, then?  He should have explained this (his fault).
You should not have insisted on calling something by its improper name,
and assuming that people trying to call it by its accepted name are all
trying to snow you (your fault).


>Second, and more interesting, I believe the scientific method is a
>fundamental part of diagnosis. When I say science, I am not referring
>solely to the tests used by the FDA or other researchers. Their methods
>are in general scientific to a point. The methods at diagnosis are in
>general not scientific. These are not scientific because the diagnosis is
>a hypothesis and presenting a hypothesis begs that the hypothesis be
>validated.


   Not always.  Quite often it isn't really necessary to make a specific
diagnosis in medicine, because the treatment does not vary between
possiblities.  If something could be A,B, or C, and the treatment of all
them is the same, why go to the expense and pain to figure out which it
is?

>Sometimes the hypotheses are tested and other times not.  Alternate
>hypotheses should be considered and tested also.

Sometimes they should, sometimes not.  Again, it is sometimes expensive
and or painful or dangerous to eliminate some possibilties, and thus it
is not worth doing unless "simpler to treat" hypotheses have proved
wrong.  There is generally a diagnostic cost in medicine which keeps the
practice of it from being pristine.  It's very much like playing
Jeopardy, where you are playing against pain and money and time instead
of another player.  You don't HAVE the luxury in most cases of being
methodical.

>I met one MD whom I consider to be the best pracitioner, scientist and
>humanitarian I have ever met or heard of. For the particular
>circumstance that we met. he made several hypotheses and set out how
>these would be validated or invalidated over time.

That is the way it should be done.  But note that there is a specific
sequence here, and "tincture of time" as well as the success or failure
of therapy, is often a key ingredient in the work-up.

>  There was a circle of
>other MD's involved who made a single diagnosis and set out to on an
>exhaustive search to prove only that diagnosis. As this single hypothesis
>was invalidated I was offered alternating threats and admonishments to
>keep me focussed on the original diagnosis.


Well, this is NOT the way to do it.  Sorry you had the bad experience.
Not all doctors are great.  A few are lousy.


>I am obviously quite bitter about some events, but I have a few chips
>that I think I can turn into food for thought. Medical diagnosis is not
>an art as some have told me: it is a skill. Art is synonymous with skill,
>but I reserve use of 'art' for aesthetics or other emotions.

Would you regard Chess as art or skill?  Would you regard fishing as art
or skill?   Would you regard 20 Questions as art or skill?  How about
somebody who was really really GOOD at "20 Questions"?

>Once the skills of the practitioner has been employed to develop
>hypotheses, the science of the practitioner is needed to test these
>hypotheses. I do not believe the second step is used often.
>
>Tom


You are probably right, but that is because 1) most things get better by
themselves, and 2) those that don't are nailed by some combination of
the first treatments tried.  It is only when time and several treatments
don't produce results that medicine is forced to be methodical.  Again,
however, this usually means money, time, travel, and pain.  If this was
the way all medicine was practiced, I guarantee you wouldn't like that
either.

                                          Steve Harris, M.D.