Great Scams in History

Cocaine and Leeches

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Having spent the last day, essentially, in the hospital with my wife I’ve decided that for all the advances in medicine over the last 200 years it still seems like doctors spend most of their time making educated guesses. Oh sure, doctors no longer believe its vapors of decaying plants that cause all illness, and they don’t regularly prescribe cocaine for children’s toothaches or leeches to “clean the blood”, but when you get down to it they make a guess as to what the problem is then run tests or give you medicine to prove or disprove the guess.

[Image Credit: Public Domain]

  • Slow_Joe_Crow

    Hey, leeches are still very useful for draining black eyes and stimulating blood flow to surgical sites.

    • windbuechse

      Yes, but last I heard, the only FDA approved medicinal leeches are imported from France.
      When my wife was a practicing nurse, there was a young boy who had 4 severed fingers reattached. He would come in with his jar of leeches that would be lovingly placed on the fingertips and rotated back into the jar as they became engorged. What struck me as interesting, the young lad had named all the leeches…

      • Ouchie, Bitey, Suckie, Piggy… Thumbelina

        • Felis_Concolor

          In the wonderful words of Murdoch, creator of the original Random J-Pop Band Name Generator: "You're Banned!"

  • Those diagnoses (guesses) need substantiation (medically and legally) before treatment can begin. The standard of care has advanced to such a state that 'knowing' what's wrong is medically unethical and leaves the doctor exposed to litigation.

    • "…leaves the doctor exposed to litigation."

      That's the crucial part. I've talked to several doctors (and even been friends with a few) that say that based on your description of symptoms and a few checks/tests, they can diagnose you with at least 99% certainty. The problem is the <1% of the time they are wrong they can get sued if the patient feels they were wronged.

      • Entering my 4th decade as a dentist, I can correctly diagnose >90% over the phone. A radiograph confirms and supports that most of the time. Occasionally, the patient needs some test that needs to be performed at a specialist or lab. If I am wrong, you might lose a tooth and have some swelling or pain. It's really hard to kill a patient as a dentist – requires dedication. Real doctors pay 10 to 50 times more in professional liability premiums than I do. They need to be extremely diligent to avoid lawyers. Also the expectations of patients, with all the high-tech procedures touted in the media, is rising, dragging the standard of care upward. At what point do we find a cost/benefit ratio that our society can accept?

        • Felis_Concolor

          I'm just amazed at all the wonderful new technology available, especially compared to the bad old days. Instead of biting down hard on those nasty film wedges while the X-ray gun's spike dug into your cheek, you now relax and let the technician orient the digital imaging sensor behind your teeth while a much less powerful beam is sent through your jaw at a distance. And the temporaries currently filling my forward quadrant look orders of magnitude better than the 25 year old double crowns which originally marked where I performed my bicycle faceplant (I can hardly wait to see how good the new tech bridgework turns out). It doesn't hurt I'm very understanding of the difficulties of diagnosis and despise the tort-heavy approach the boomer generation is inclined to foster. We started out with "how bad is it; do I need to look at full implants?" to "heck, we can save most of what's left here and you'll only need a plate for 6 months." And of course I love hearing the magic word: laser beams! Fricking laser beams in the dentist's office! I'm living the freaking future here!

          I guess I've always known things could be much, much worse in my sheltered and pampered life, so making others' lives miserable via the courts is anathema. Yes, the doctors' failure to inform my parents of a congenital heart condition in my retarded sister – and one which could have been fixed with a then simple operation – took her from us at the far too young age of 25, but we never once considered unleashing the lawyers.

          • You're my kind of patient. One who understands and appreciates the services and results that are possible. 80% of dental procedures taught in the late 70s are now obsolete and have been replaced by marvelous technologies. Not all of these tech marvels are mature or successful and many are foisted on the profession by manufacturers looking for a new market. Often times the dentist is unwittingly using the patient as a test subject for a system/restoration with no track record. These guys are known as First Adopters. Again, pioneers are identified by the arrows in the back. Here's what excites me, 3D implant and restoration printing:
            [youtube qvl_O1M5Ykk http://www.youtube.com/watch?v=qvl_O1M5Ykk youtube]

          • It seems to me that high tech tools in medicine are much like high tech tools in engineering. I can use MathCad to do a calculation for me, but it has quirks and foibles. If I don't know what a reasonable answer is, or understand what it should be doing "under the hood", then it could give me a garbage answer and I will go with it. No matter the tool — whether a calculator or computer program — I need to know what the basis of the calculation is to understand what a reasonable answer should be.

          • Scalpel vs laser, vector log-log sliderule vs MathCad – how close is close enough? This is where the grey area occurs. What is the acceptable cost/benefit ratio? We got to the moon with sliderules, can we treat patients effectively with greymatter rather than gadgets? Can the gadget drastically improve the treatment without increasing its cost by an exaggerated amount? Are we allowed to make reasonable guesstimations? Only if we are correct, and the answer is often ambiguous, hence the need for litigation to dictate the right answers.

          • Felis_Concolor

            Wow, that is amazing; I can see how that custom laser sintering would be a godsend for special cases or areas where bone erosion can make reconstruction problematic.

            I'm also looking forward to how well this will help my own diet, which has been forestalled due to the inability to heartily consume the nuts and harder fruits and vegetables I have come to crave.

            One bit of modern tech which helped me these past few months has been a well stocked ereader; during the temporary break periods when I was returned to an upright position, having the reader handy to return to the short stories I was consuming made those waits for the molds to set far less unpleasant than they had been in the past.

  • Wait, so he's sticking his finger in my butt on a guess?

  • John McAfee will tell you … where there's cocaine, there's leeches.

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