When Do You Just Keep Your Mouth Shut?


My mother is currently renting a small holiday apartment in a nearby town here in Germany, so that she can both escape the Italian summer heat, and do some much needed exercises in the thermal baths in the area. When I was visiting her this weekend, her landlord stopped by for a chat. He almost immediately informed us that he has metastatic cancer, with a tumor in his brain, as well as many small masses in his lungs, lymph nodes, and other places throughout his body. I was, of course, devastated to hear this. I doubt he has much longer to live, and it was really sad to find out that such a nice (albeit quite odd) man was going through something so terrible.

But then the conversation took a turn that made me very uncomfortable indeed. My mother asked him if he was doing any treatments, and he informed us that he was doing Gerson Therapy. “Oh! I’ve heard of that! It’s supposed to be really good!” my mother exclaimed. “There’s a Gerson clinic in Hungary right? And in Mexico! Maybe you should think about staying some time at the clinic!” Uh-oh. A cancer treatment my mother has heard of, is enthusiastic about, and is only done in Hungary and Mexico? Quackery alert. He then proceeded to tell us that the bulk of the therapy consisted of drinking gallons of juice made from nettles, dandelion leaves, apples and carrots. Oh dear.

Well, a quick internet search a few hours later confirmed my suspicions that this is, of course, yet another woo-based “naturalistic” cancer quackery, and my heart sank for the man. However, it got me thinking, at what point do you keep trying to dissuade people from falling into pits of alternative medicine garbage, and at what point do you keep your mouth shut?

I have posted before about the potential harm of perpetuating the placebo effect. If I were a doctor, and a patient of mine asked me about Gerson therapy, I definitely would not encourage them to do it. However, when it comes to casual conversation between acquaintances, or even between friends and family, it can get far harder to draw the line.

This man was clearly not forgoing science-based medicine completely. He had regular visits to the oncologist, and had already had at least three operations to remove some of his lymph nodes. What most likely happened was that his doctors explained that there was little more they could do, and so he decided to buy Gerson’s books and try this diet in parallel with his medical visits. He said he felt better, he has lost a lot of weight and has more energy, so the placebo effect does seem to be working on him, as he is also full of hope that this therapy will at least prolong his life. On the other hand, he told us about all the food he is not allowed to eat which he misses, but that giving up cake and alcohol and such things are a small price to pay if this treatment actually does save his life.

This is the sticky part for me. On the one hand, I don’t want to shit all over this man’s hope. Maybe living the last year or two of his life with hope and promise is the happiest way he could be spending this time. On the other hand, how much are his sacrifices costing him, when they will do nothing to save him from cancer? Would he be happier not denying himself the cakes he loves so much, or the holidays he’s not taking, rather than living his last days within a ten minute radius of a toilet for fear of wetting or soiling himself?

At what point do you just shut up and smile? At what point do you stop arguing, stop fighting for reason and science?

For me, there is a hard line when it comes to doing harm. If he were not seeking real treatment at all, I would have said something, even if he thought me interfering and arrogant in doing so. I simply can’t have a clean conscience if I don’t at least try to inform someone who is forgoing medicine for nettle juice. However, if there is nothing that person can do, if all possible medical treatment has been exhausted, and there is nothing left but to wait out the inevitable?

In this case, I did not say anything. I do not know this man at all, and it is not up to me to decide how happy he will be living a lie, or not. I think that, if he were a close friend or family member, I would try to convince them not to go for woo, but I wouldn’t insist if they had their mind set on it. When it comes right down to it, everyone has the right to decide how they want to live out their last days. Of course, in an ideal situation, they would make that decision fully informed, rather than based on lies and empty promises. However, there is a great wide world of information on the internet, and I really do think that some people are simply chasing a happy delusion. Some people really do prefer the feeling of hope to the harsh reality of truth. As I have mentioned before, I am not one of those people, but it really is not up to me to judge how other people find comfort.

What about you? Where do you stand on the fight against woo? Would you have spoken up, in this case?

Comments

  1. Siobhan says

    I think you made the right choice, since his condition is fatal and at this point irreversible. You would’ve been dealt a very different hand of cards if his condition was on the cusp of the point of no return, at which point I’d argue one is compelled to tell him to seek real treatment. But that was not this scenario.

  2. says

    When someone is terminal, I go with keeping my mouth shut. At that point, it’s more about the person managing their death, and I think people should be left to do that in whatever way they see fit.

  3. says

    I had a similar issue last year, when a friend of mine’s husband was dying of pancreatic cancer. She kept asking me about this quack therapy or that quack therapy, and I finally told her that if any of these quack therapies worked, every oncology center would be pushing patients to try them – just like they pushed gamma knife and chemo.

    The Gerson diet is marketing to get people into Gerson’s clinics; that’s where the dying sheep really get shorn.

    What sucks is that when someone gets sick it’s inevitable that there will be a few woo-woos in their circle of friends who will suggest bogus treatments. My friend was constantly getting helpful advice from complete strangers on facebook – you know, like “all you gotta do to cure pancreatic cancer is pray really hard.” I wound up being the voice of reason and that meant I was implicitly aligned with the cancer, so that relationship was ruined.

  4. smrnda says

    I’ve never known anyone to rely on alt-med for a serious ailment, but I know of quite a few people who go for homeopathic remedies, acupuncture, reiki (sp?) healing and various ‘juice cleanses’ for minor ailments or mostly physical discomfort. So far I rarely say anything, except once when someone who was going on about how ‘we don’t know’ the possible harm from some Rx drug – and I had to say that, at least Rx drugs are tested for efficacy and safety, and that ‘supplements’ aren’t testing at all.

    I do worry that a problem is people will start small, but then be more likely to rely on alt-med for serious things.

  5. perodatrent says

    The late physician Richard Asher (inventor of Munchausen syndrome) put it in this way: “It is better to believe in therapeutic nonsense than openly to admit therapeutic bankruptcy. Better in the sense that a little credulity makes us better doctors, though worse research workers”.
    Unfortunately, we must accept our patients’ choices, even if we know for sure that they are at best useless, at worst dangerous.

Leave a Reply

Your email address will not be published. Required fields are marked *