Dr.Garber’s Blog

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The successful use of homeopathic remedies for disease prevention has been around for over 200 years, even before Jenner developed his smallpox vaccine, with documented studies dating back to 1907. Known as homeoprophylaxis, and commonly (although not quite accurately) called homeopathic vaccination, the process makes use of special homeopathic remedies called nosodes. I discussed the use of one particular homeopathic nosode, Influenzinum, in my recent blog post on swine flu.

Now, the largest known trial of homeopathy for disease prevention has been conducted with remarkable results. Researchers at Cuba’s Finlay Institute, a scientific organization that researches and produces vaccines, recently reported on their successful use of a homeopathic remedy to prevent an outbreak of Leptospirosis, a tropical bacterial disease. 2.4 million at-risk Cuban’s received the Leptospirosis nosode prepared by the Finlay Institute and administered through the Ministry of Health’s public health system infrastructure. Epidemiologists noted a “dramatic decrease in morbidity” and also that confirmed cases were “at low levels and below the expected levels.”

The Finlay Institute has offered it’s facilities and specialists “to all regions needing emergent alternatives for epidemic control and prevention.” The low cost and ease of administration of homeopathic nosodes has the potential to make a huge impact on the world’s health, especially in countries where public health measures are still substandard.

In yesterday’s blog on labs I discussed the potential fallibility of lab tests. When I run lab tests on a patient and a result comes back as abnormal, if it doesn’t make sense to me in relation to the overall clinical picture, the first thing I do is re-run the test. Nine times out of ten, the test comes back normal. Why the first abnormal finding? Chances are it was  some technical glitch (many lab tests are automated) or due to an overworked technician as described in the previous blog post. When an abnormal test does come back, and it’s consequences are dire, a second opinion, in such a case having the same test run by a different lab, is prudent.

But what happens if there is no other lab? As reported in today’s New York Times, a woman who received a diagnosis of breast cancer wanted to find out if she had the genes than would also put her at an increased risk for ovarian cancer. She took the test and it was positive, a result with serious ramifications. As I stated above, the prudent thing to do at this point would be to get another opinion, in this case, have the test run by another lab. As it turns out, this is not possible as the government had allowed the company that does this test to own the patent, not just on the test, but on the genes themselves!

The woman, Genae Girard, along with other cancer patients, pathologists and genetic researchers, are suing the company as well as the US Patent Office. According to the Times article, this case “blends patent law, medical science, breast cancer activism and an unusual civil liberties argument in ways that could make it a landmark case.” I for one am very interested to know it’s outcome and will be sure to blog more about it as the story unfolds.

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• Cancer Patients Challenge the Patenting of a Gene (nytimes.com)

A recent “whistle-blower” case against Quest Diagnostics resulted in a $302 Million Dollar settlement, one of the largest of it’s kind, because of certain inaccurate and unreliable testing performed by one of Quest’s subsidiaries. In another blog discussing this case that I came across, a former Quest employee made a comment that, while it didn’t surprise me, it did scare me. She was a cytologist reading Pap tests, a screening test for cervical cancer. She states that she could read 60 slides per day with accuracy but was pushed to read at least 75 to appease shareholders and to ensure bonuses for her department. She finally quit because she discovered so many missed cases. Your doctor makes decisions that effect your life based on the results of these tests. You and your doctor have the right to expect accuracy from the labs that they use. Giant corporate labs may have some advantages, but the smaller independent labs, although a vanishing breed, still offer the individual attention that can make a big difference. Which lab does your doctor use? Ask!

The Sunday New York Times Magazine has a regular feature called Diagnosis. Each week a doctor presents a “mystery” case, one that on the surface defies a typical clinical workup. Today’s case, describing a condition that developed as a result of a tumor in the Pituitary gland,  was as intriguing as any other I have read. But what I found fascinating, no, make that mind-bogelling, was one statement made by this particular doctor. In discussing this patient’s history she described the various symptoms produced by his tumor as being relatively common problems and that because they had developed at different times and had each been addressed by a specialist that “It would take an act of imagination to link these symptoms. The patient never made this leap, and neither did any of his doctors.” This is exactly where the problem lies in the world of medical specialization. No one sees the forest for the trees. Each specialist this patient saw looked only at one particular symptom. Not one stepped back to look at the man - the whole man. Had anyone bothered to do this, fifteen years of suffering might have been avoided. This is what holistic medicine is all about, taking into account the totality of a patient’s symptoms, and doing so within the context of that patient’s story. And contrary to the writer’s opinion, it has been my experience that even when all the attending doctors haven’t made that “leap,” the patient usually has. A very wise professor of mine used to say, “Just listen to your patients. They will give you the diagnosis.”