Editor’s Note:
Introducing Fayston resident Dr. Larry Consenstein as a Valley Reporter columnist.
Consenstein is a retired physician (newborn intensive care) with an interest in the social issues connected with healthcare. He is a native of New York who graduated from SUNY Medical University where he completed his residency in pediatrics before practicing medicine in Syracuse. He and his family have lived part-time in Vermont for over two decades and he and his wife Celeste Madden have been here full-time for the last decade.
There has been a great challenge to fundamental scientific principles in the last year, as well as broad cancellations of important scientific and medical research. Over the last decades we have seen a significant decline in serious infectious disease, largely because of the development and broad use of safe and effective vaccines. I am old enough to vaguely remember summers when there were polio epidemics. We couldn’t play with other kids, go into swimming pools, and lived in fear of contracting a disease that was potentially life-threatening or crippling, leaving us dependent on an iron lung. Then there was the amazing discovery of the polio vaccine. Almost overnight we were liberated from the fear of this terrible disease. I also trained in pediatrics when children contracted H. influenza, a bacteria that caused life-threatening spinal meningitis, blood infections or infections of the throat. Again, when a vaccine was developed these illnesses almost disappeared and generations of parents no longer had these fears.
So, was this the result of investment by the National Institutes of Health, hardworking doctor scientists, and pharmaceutical companies, or something else? How do we sort out claims that improvements in these illnesses were due to improvements in diet, weather, or something else entirely, but not the immunizations?
Illnesses are prevented and mitigated by many factors. It is not one or the other. It is all the above. Better medical care, diet and exercise will result in better outcomes for these illnesses, but an immune system that has been trained by a vaccine to identify and root out specific infections, is the best, and even better when combined with modern good care.
The way we should sort out claims of benefit, or challenges being leveled against established practices, is to think about whether a particular outcome (such as the benefit of a wellness practice, an apparent vaccine injury, or chronic disease) is due to or just occurs in association with the established practice. Just because two things occur at the same time doesn’t mean one causes the other. An example I recently saw was a graph showing how the divorce rate in Colorado perfectly correlates with the decrease in milk intake. Does less milk cause divorce? I doubt it.
Another reason many people mistrust advice they are being given by health care providers is that they are suspected of being “corrupt” or taking money from drug companies to recommend specific drugs or treatments. In this case it is true that drug companies make money from certain treatments or drugs, but there is no evidence that doctors are being paid to prescribe specific drugs. Doctors rely on their years of experience, years of education, and understanding of how to detect bias in research. And new practices don’t get incorporated into standards of care until the research has been reviewed by many experts, whose expertise is both in their field and in statistical methods used to decide whether the results claimed were properly determined.
These days we may think we are checking medical information adequately by “doing our own research.” This is not so easy to do, unless we understand the science, the history of that research, and the statistics used to evaluate the results. This is not something we can just Google.
