The next few blog posts were initially made on an older version of my site. I've decided to port them here in case anyone is interested.
Before we get started, I’d like to give you a little background on me - just in case you haven’t met me. Even if you have, I’d like to provide a little more detail.
I grew up in a household that valued reason and individuality. My father is a typical blue-collar worker with a particular genius for machines and fixing things. A gene I, unfortunately, did not inherit. My mother is a chemist and ran a reference lab in my home town. We always had books in the house. I can’t recall a time when I didn’t have a library card. A common refrain from both my parents when confronted with a question was, “Go look it up.” Not because they didn’t want to be bothered with questions, but because they wanted us to understand how to acquire knowledge, think critically about the information and fit it in to our own worldview. A wise old pharmacist friend once told me, “Real knowledge is 20% knowing the answer off the top of your head and 80% knowing where to go to find it.” A statement that stuck with me and that I’ve found generally true in my own life.
Science was one of my favorite subjects throughout school and I graduated high school with 2 years of chemistry, 2 years of biology and a year of physics along with algebra, trigonometry and calculus. My original college plan was to major in chemical engineering. That changed to chemistry, then biochemistry and eventually anthropology with an emphasis on physical anthropology and a related field in biology (more or less an unstructured minor). My college course work in sciences included: chemistry through bio-chem, two semesters of physics, geology, a lot of biology and math through differential equations.
Many folks don't realize what kind of education is required to become a licensed acupuncturist in the US. The minimum requirement to attempt boards is around 1900 hours of education with 500 documented patient contacts in student clinic. Usually this is a master's degree, but there is at least one school in the US providing a master's certificate. Most programs are well over 1900 hours, and most schools are moving towards doctorates as the standard. My master's degree was a little over 2200 hours and then I put the doctorate on top.
Master’s degrees in Chinese medicine are fairly heavy in western science; they are MS degrees after all. My graduate degree added things like western physiology, pharmacology, western medical intake/exam, western medical pathology and microbiology. In fact, about 1/3 of the course work for oriental medicine is western science or western medicine. One of the three national board exams, which must be passed for licensure, focuses exclusively on western bio-medicine and diagnostics.
I worked in pharmacy as a technician for 10 years. Then I took a job in the healthcare IT industry first as a software tester and later as a software developer. The first company I worked for designed, programmed and sold hospital IT systems. The second company I worked for was a large health insurer. I’ve been in the medical industry in some form or capacity for 30 years.
Why do I bring all this up? It’s because the next several blog entries are going to be an examination of knowledge and science. I highlight my background because this is not an attack on science or western style medicine. I like science. I spend lots of time looking at science and scientific research both inside and outside the medical field. Because I’ve spent a great deal of time studying science, I recognize that it has a particular approach to the world and that approach brings with it some limitations. Modern science, with its reliance on empiricism and material-reductionism, has brought us a long way but it is not the only valid way of looking at the world.
People, no matter their education level, can become fairly dogmatic about what science says and doesn’t say along with what it can and cannot know. Some science popularizers, in their attempt to break things down and make them more understandable, have left folks with an over-simplified set of ideas. And then we have cognitive biases that come in to play.
My hope with this series of blog posts is to provide a basic understanding of how knowledge works; how we can know that we know what we know. To shed some light on the interaction between the basic sciences and clinical science. To understand how our paradigm or framework for interpreting the world affects how we approach science and knowledge in general. To bring some clarity to how randomized controlled clinical trials work as well as what they can and cannot say in terms of their evaluation.
At the end, I think people will see a few things:
Modern science has limitations. There are questions that it cannot answer due to the foundations upon which science sits.
Some of the foundations of science represent current consensus, are not necessarily fixed and, if changed, would allow a more broad based approach to the universe without sacrificing scientific integrity.
The practice of western medicine isn’t really as ‘scientific’ as one might think.
The practice of east asian medicine and acupuncture is at least as ‘scientific’ as the practice of western medicine.
Do I believe this blog series is going to change the mind of those who are already dogmatically opposed or those who take pride in the fact that, once their mind is made up, they never change it? Probably not, but hope springs eternal.