DOUBLE-BLINDED MEDICINE: When Doctor and Patient Are Both in the Dark

DOUBLE-BLINDED MEDICINE:

When Doctor and Patient Are

Both in the Dark

I met a dermatologist the other day who made my skin crawl. He was in his thirties, tall, lean, and unsmiling, like many doctors these days. But what stood out most was a fresh-looking, full-color, eye-popping tattoo on his right arm that snaked its way up from his wrist, circumvented his forearm, and slipped beneath his short-sleeved shirt to unknown anatomical areas. I believe he also had a tattoo on his left arm, but I was too gobsmacked at the time to take note.

Now, you might think, as I do, that a tattooed dermatologist is an oxymoron. It doesn’t take much imagination, or research on the Internet, to realize that tattoos are bad for the skin.

The most obvious issue is that tattooing is done by puncturing the skin, causing skin trauma and risk of infection. Interestingly, there is research that connects the injury to the skin made by both tattooing and vaccinations as a cause of numerous skin reactions, including cancer.

The 2014 article, “Tattoo and vaccination sites: Possible nest for opportunistic infections, tumors, and dysimmune reactions”, in the journal Clinical Dermatology, explains that, “Both dermal tattoos and vaccine injections may alter local immune responses, creating an immunocompromised district on or near the site of placement. This can lead to the development of opportunistic infections, benign and malignant tumors, and local dysimmune reactions… A variety of tumors including basal and squamous cell carcinomas, keratoacanthomas, and malignant melanoma also have been reported in association with tattoos… Vaccination sites similarly provide a setting for both benign and malignant tumors.”

The inks used are also a problem, causing allergies and exposure to heavy metals. It is fairly common for individuals to have an allergic reaction to the dyes used in tattoos. Ink is actually filled with many chemicals and unnatural ingredients that can irritate a person’s skin.

There is also a link to skin cancer. When it comes to cancer, black ink can be especially dangerous because it contains a very high level of benzo(a)pyrene. Benzo(a)pyrene is currently listed as a carcinogen by the International Agency for Research on Cancer (IARC). Black ink is the most commonly used color for tattooing.

You might think that this doctor may have gotten his tattoos before becoming a doctor, so he didn’t know any better. But this was a new tattoo. And he was flaunting it, not hiding it.

Tattoos are common these days, and fashionable in certain circles. Doctors want to look cool, like everyone else. They grew up like everyone else, exposed to, and brainwashed by, the same cultural messages. They just choose to go into medicine.

I also met a cardiologist who smoked cigarettes. He was also grossly overweight, and ate a big, juicy hamburger with fries for lunch. Of course, being obese, smoking and eating fried foods can increase heart disease.

An obese, smoking cardiologist eating fast food makes as much sense as a tattooed dermatologist.

Maybe these doctors are attracted to their specialties because they know they will need treatment from that specialty due to their lifestyles? It’s like when mentally-disturbed, neurotic people become psychologists or psychiatrists.

How about female doctors who constrict their breasts with tight bras for long hours daily? There are many female breast health experts, including breast surgeons, who wear breast-harming bras. Their medical training never mentioned tight clothing as a cause of circulatory impairment and lymph stasis. These doctors willingly immobilize and alter their breast shape, hide their nipples, and basically re-design their breast appearance for cultural reasons, and do this despite the documented harms caused by bras, including causing breast pain, cysts, and cancer. Wearing bras is just something every woman is culturally expected to do, even doctors.

Is this hypocrisy? Should we expect doctors to be paragons of health and healthy lifestyles?

More basically, when we seek help, does it matter whether the helper is in the same mess we are in? In other words, can you trust a lifeline from someone in the same boat as you?

We seek help in many places.

Would you go to a priest who was a known pedophile?

Would you use a mechanic whose car is broken down?

Would you go to a hairdresser who is having a “bad hair day”?

Would you use a plastic surgeon who has a big nose, cock-eyed chin, and facial scars?

How about eating in a restaurant where the cook is out because of food poisoning?

You could also go into a health food store and buy chips, coffee, candy, wine, beer, and lots of other unhealthy stuff.

Then there are the drug addiction recovery programs that offer coffee to everyone, one of the most addictive substances we consume.

Clearly, there’s a problem here. We live in a culture where there are lots of products and activities that can harm us. In fact, the biggest cause of disease and death is the culture and all the bad things it teaches us to think, do and feel. We absorb these cultural messages from the uterus onward, as our nature becomes modified by our culture.

This applies to everyone. It includes doctors, too. Just because someone studied medicine, it does not mean that they personally eliminated all harmful cultural practices in their lives. The same cultural causes of disease that fill their waiting rooms also fill their personal lives. In fact, the medical culture is even worse on doctors.

For some reason that is not clear, the medical system exploits doctors with long work hours and sleepless day and night shifts. Doctors are rushed and pressured, grabbing unhealthy snacks on the go. They become tempted to abuse drugs to keep going, but may settle for drinking 10-20 cups of strong coffee, instead. They also become tempted to use drugs to relax, but may settle for a few alcoholic drinks. They have little recreation time, or time with their families. And depending on their specialty, they are exposed daily to infectious diseases, death, radiation, the soul-robbing sights and smells of hospitals, and the depression of treating endless lines of sick people, often using treatments that do no good, and for conditions that have no known cause.

Clearly, being a doctor can make you sick, mentally and physically. No wonder why there are so many doctor suicides. Just practicing medicine is slow suicide.

This also means that doctors are not the ones to tell patients to clean up their lifestyles. The doctor’s lifestyle is at least as bad, and actually worse. They participate in the same unhealthy culture as everyone else, addicted to many of the same things, and suffering from the same psychological and physical issues. But they are the ones who are meant to treat those problems.

Cancer Immunotherapy Use on Cancer Patients

Recent advances in treating cancer patients have resulted in the development of biological therapies that can prove to be a promising alternative to conventional cancer therapies. Immunotherapy harnesses the body’s immune system to identify and fight effectively against cancer cells.

Immunotherapy works by attacking the growth of cancer cells or stimulating the immune system to kill cancer cells. Contradictory to the standard cancer treatment regimes such as chemotherapy, radiation therapy, which act on both normal and cancerous cells, immuno-therapeutic treatments are highly specific. A wide range of cancer immuno-therapy approaches exists such as immune checkpoint blockers, cancer vaccines, immune-modulators, monoclonal antibodies and cell based immuno-therapies have demonstrated to be effective against cancer patients.

The most commonly targeted form of cancer chemotherapy is the use of monoclonal antibodies as they can be tailor-made in the laboratory. They have unique antigen specificity thereby allowing themselves to attach to specific epitopes on cancer cells. This flags the cancer cells and makes it more visible to the immune system so that it can find and destroy those cells. Currently, most of the monoclonal antibodies are undergoing phase 3 clinical trials or awaiting FDA review process. Unlike monoclonal antibodies, non-specific immuno-therapy approaches such as administration of immuno-modulatory cytokines are also being used to treat melanoma. Cytokines are hormones that are endogenously produced by the body to enhance or suppress T-cell response against cancer cells. IFN-α and IL-2 are most commonly characterized cytokines used in cancer immuno-therapy.

The primary cell-based immuno-therapy strategy which is successful these days is the use of T-cell therapy, wherein cancer T cells removed from blood are modified with chimeric antigen receptor (CAR) and is then infused back into the patients to treat metastatic cancer. Another form of cell-based immuno-therapy used is tumor-infiltrating lymphocytes (TIL) therapy, wherein TIL is surgically removed from tumor tissue and is considerably increased in the laboratory by adding cytokines to it and is then re-infused back into the patient.

A promising treatment that has emerged in recent times for treatment of melanoma is the use of immune checkpoint inhibitors. They act by inhibiting the checkpoint receptors on T cells that act as brakes to the immune system thereby mediating anti-tumor responses. Some of the commonly used antibody inhibitors that have been commercialized are PD-1, PDL-1, and CTLA-4. Another more focused approach to cancer immuno-therapy is the use of vaccines to encourage the immune system to generate antibodies that can target tumor specific antigens, thereby eradicating cancerous cells. Cancer vaccines include peptide-based, dendritic cell-based, tumor cell-based and DNA cell based. Cancer vaccines can be broadly classified as preventive or therapeutic. Preventive vaccines are commercially available for against cervical and liver cancer causing viruses such as human Papillomavirus and Hepatitis B virus, respectively.

However, in spite of these advances, limitation such as tumor heterogeneity, unpredictable efficacy and identification of potential markers still exist in the field of cancer immuno-therapy. Therefore, new more targeted cancer immuno-therapies and preventive strategies are being developed and tested, which will deliver novel efficacious therapy against relapsed or refractory cancer patients.

A Healthy Dose of Medicine for the Soul

A large segment of the human population takes things way too seriously for their own good. The strange anomaly is that most people laugh at the wrong thing and fail to laugh at the right thing. This serious incongruity has robbed people of a healthy attitude towards life in general.

Those who take life too seriously are in danger of missing the great joys of living in a crazy world like ours. I am not sure about the scientific research but I would guess that for every sad moment it takes one hundred laughs to balance the books. Some people are about ninety-nine laughs short of a real sane moment.

I like the old English proverb that says, “Laugh and the whole world laughs with you, cry and you cry alone.”

From my perspective, if you cannot laugh with someone you will not be able to cry with him or her and have it mean anything.

According to some medical advice, it takes more facial muscles and energy to frown than it does to smile. Of course, the only exercise some people have is frowning and who am I to take that away from them.

I am determined, no matter what, to exercise my right to smile and laugh and enjoy the world around me. I must confess that I get this attitude quite honestly.

My paternal grandfather was a Past Master in the area of practical jokes. No amount of time was too much to spend preparing for one of his famous practical jokes. His favorite holiday was April 1 and began preparing for this holiday right after Christmas.

The fact that his practical jokes at times got him into trouble did not seem to affect him at all.

Once while in the hospital for an extended period he had somebody smuggle in to him a can of snuff. For some reason he liked chewing snuff. It is the most disgusting habit I know of on earth.

He no sooner received his smuggled goods then he began chewing it. If you know anything about chewing snuff, you know it is accompanied by a lot of spitting. As usual, his timing was impeccable. Just as the head nurse passed his door and looked in, he leaned over and spit in to the garbage can he had next to his bed. The nurse, not knowing about the chewing snuff, thought he was spitting blood and immediately went into emergency mode. Immediately my grandfather was rushed into the operating room and the surgeon and medical team were assembled.

My grandfather was very sick at the time. Some did not think he would get out of the hospital.

Just as they got him situated in the operating room he pulled from under his sheet his can of chewing snuff and smiled at them. The only person in the room that thought this was in any way amusing was my grandfather. The doctors were so angry with him that they refused to see him for three days and confiscated his can of chewing snuff.

My aunt and uncle lived right next to my grandfather. My aunt was hyper clean when it came to her house. Dirt in any form was not welcome under her roof. She had a broom that was always within reach because she never knew when a piece of dirt would try to invade her domicile.

That year my grandfather found something new. I am not sure where he found it but he probably spent a lot of time looking for something like this. It was a rubber facsimile of a very nasty looking piece of vomit. To him it was a prized possession.

Most of his practical jokes were executed on April 1. Whenever we saw grandfather coming on this particular day we usually ran for cover.

He went over to visit my aunt and was sitting on the couch in the living room. They chatted for a little while and then my grandfather began to cough a little bit. He said to my aunt, “I haven’t been feeling good lately. I really don’t know what it is.” Then he started to cough a little more seriously, to which, my aunt got up and went to the kitchen to get him a glass of water thinking that might help him.

When she got back, she was shocked to see on her new coffee table a very horrible sight. My grandfather was bent over the coffee table hacking and coughing as though he was in the process of dying. On the coffee table was a very nasty looking piece of vomit.

My aunt went into hysterics. She whirled around and within a moment had grabbed her broom and started towards my grandfather. My grandfather was laughing but not for long.

Suddenly he realized that the flailing broom in my aunt’s hand was aimed at him. She chased him out of the house, down the driveway and for at least three blocks yelling obscenities at him that I dare not repeat in public society.