Lately I've had cause to spend a little time thinking about alternative treatments. Not for myself, but because I've been asked for my opinion about one in particular. I'm not going to rail against them again as I've made my stance abundantly clear: they're harmless at best and criminal at worst.
Rather than sit here and fume about the cruelty of these self-proclaimed "renegades," fighting the "corrupt mainstream medical conspiracy," I've wondered why they seem to get so much traction. I think it's more than simply offering a cure to the desperate, in part because the individual asking me my opinion seemed to already have a quite skilled doctor. From what I understand of this patient's diagnosis, their prognosis is about as good as it gets when it comes to brain cancer. Low-grade, very little enhancement, no progression... Controlled. Even so, they came away with the impression that their doctor told them to go home and quietly die if they so please. Their doctor may be skilled, but not terribly personable. They were so frightened they didn't want to get a second opinion out of an unwarranted certainty that the next doctor would give them even worse news, or insist they go through radiation or chemotherapy. So they asked me what I thought about Burzynski. And I told them. At length. I was less than complimentary and at one point I think I may have wished cancer upon Burzynski himself.
That kind of heat is pretty rare from me, but I'd like to think it came from a good place. I was not angry at Burzynski for lying (I mean, I am, but that's not where I was coming from at the time). I was worried about the other patient, and that they might put their health at risk chasing a false hope even though - as shown by yesterday's post - there are plenty of real reasons to have hope. I was worried that Burzynski's unsupported optimism would overcome their doctor's unwarranted pessimism.
So what is it that makes a false cure more appealing than a real one?
For one, lies are a lot more flexible than truths. Everyone peddling an alternative medicine can twist (or outright forge) figures to make their product look like a miracle cure. It's easy to say that their treatment works so well that it constitutes an existential threat to modern medicine itself. Crying conspiracy is a very useful tact: any lack of evidence or any evidence to the contrary can be dismissed as part of the conspiracy. We see it in politics all the time. Meanwhile, legitimate doctors with legitimate treatments are constrained by these little annoying things we call "facts," and when it comes to brain cancer, the facts aren't too pretty. They used to offer no real hope at all. Even today, that hope is slim and preliminary. Except it's real, and that's the important part.
There's also the matter of what drives people to become con artists, what drives people to become doctors, and what makes someone a leading con artist or a leading doctor. The most famous con artists are the best liars. The ones who make the biggest promises, who assemble the best false evidence, and the biggest followings of supporters who are so desperate to believe, they will fight that con artist's battles for them. I'm sure if Burzynski's followers find this post we'll see an excellent example of that. I sometimes wonder if the cons believe their own con; if they are not liars but are simply deluded. I'd really like to think that. But whether they are lying to themselves or to others, the hallmark of a great con artist is appealing to their target. They are salesmen. Selling is what they do best.
A medical researcher has no such aspirations. They deal in facts and speak factually, even when the facts seem grim. They build a career by doing good science, not by sales figures. They build a reputation among other scientists, who know that reality is not determined by popular opinion. People who know that, if every man, woman and child on the planet holds a false belief, that belief remains false. That 7,000,000,000 people can be wrong. Sure, bedside manner is important and I've found that the best doctors not only know their facts but can also relate them to their patients, but a doctor who gives you the wrong information in a gentle way is not a good doctor. First and foremost, we want our doctors to be right.
Even when the truth is terrible.