Monday, February 14, 2011

Do you need special machinery to EKG a broken heart?

Valentine's Day, of course, can be expected to produce its share of touchy-feely feature stories masquerading as "news." But this kind of thing from my local paper is indefensible in my view, as well as altogether unhelpful to our attempts to restore sanity to a post-Secret society. By (purposely?) confusing the heart's functional and metaphorical roles, the author, reporter Milton D. Carrero, makes an earnest attempt to force-fit medicine into a more pleasantly romantic framework appropriate to the day.

And while one should not in principle question the validity of emerging medical specialties like neurocardiology
after all, there's nothing wrong with trying to know everything there is to knowgiving full standing to these disciplines in their early infancy, when there are still so many question marks, too easily plays into the hands of those selling pseudoscience and New Age-inflected mumbo-jumbo. Which helps explain why, aside from instances where this article deals in speculation and thus is not provably right, there are other respects in which Carrero's quest to over-sentimentalize the heart's role in human affairs goes completely off the rails ... Witness, his entire analysis of beta-blockers' well-known role in quelling performance anxiety. The author states that since beta-blockers work only on the heart, not the brain, there must therefore be some magical way in which a calmed heart reassures an anxious brain. Let's see ... how shall we put this? How 'bout: WRONG. To begin with, his premise is flawed; beta-blockers do indeed exert a direct action on the brain, though some are more capable than others of penetrating the so-called blood-brain barrier. But Carrero, not to be deterred, goes on to give us this whimsical, beta-blocker-induced "conversation" between Mr. Heart and Ms. Brain.

...after realizing that the heartbeat has remained stable and that there are no physical signs of anxiety, the brain accepts the commands from the heart, overruling its need to be anxious.

"The heart is saying no, so I guess I won't be anxious then," said Goldstein.
Just to clarify, "Goldstein" is Dr. David S. Goldstein, one of several highly placed sources that Carrero somehow enlists in his cause (and a guy who, I suspect, will be working at NCCAM before long). A related story by Carrero in the same issue, which I was unable to link, again evokes the mythology surrounding the heart's mystical role in human emotions, describing the plight of a woman who nearly died of a "broken heart." Only later in the piece, after some paragraphs of florid prose, does Carrero reveal that in addition to whatever emotional demons the woman was beset with, she was eventually determined to have an apparent leak in her heart that was causing major bleeding into her pericardium.

I'm no cardiologist, but that just may have had something to do with her pain and other symptoms, ya think?

20 comments:

a REAL MD said...

Very good, Steve. It is sad to see so many members of my profession take medical science so far away from its roots and core competencies. It gets a little bit worse every day.

Steve Salerno said...

Real, let me append your comment with, "...thank in no small part to our TV friend, Dr. Oz."

a/good/lysstener said...

I admit I'm not a huge fan of that type music, but your Valentine's song made me tear up. Yes, she is very pretty as well.

Cosmic Connie said...

The New-Wage hucksters have been into heart "science" for a few years, via The Institute of HeartMath, which is a clearinghouse for both scientific and, I'm sure, pseudoscientific, research, as well as (of course!) a product line.

http://www.heartmath.org/

Just look at some of the big names who have been involved with HeartMath:
http://images.heartmath.com/miscellaneous3/maestro09.html

I also vaguely recall an ad that was playing on TV, at least in my area, a few years ago. As I recall, the spot called for participants in a study of a new heart drug. What made my jaw drop was that it very much played on the theme that the heart was more than a pump; it was also, the commercial claimed, the seat of our deepest emotions. No mention of the brain... At the time I couldn't believe that anyone in the medical/research establishment could endorse such an idea. (I wish I could remember the name of the sponsors of this commercial; I'll dig in my archives to see if I have it somewhere.)

And, of course, "neuro" is all the rage these days; a couple of years ago Mr. Fire even invented a new science called "neurometaphysics." On a more serious side, "neuromarketing" researchers are trying to discover new ways to penetrate our brains (oh, yeah, and our hearts) so we'll all be good little consumer slaves.

PS ~ Another Valentine, for fans of the late Eva Cassidy (pardon the cheesy video accompanying the song) http://www.youtube.com/watch?v=dDy3lQYPzS4

Steve Salerno said...

Connie: Oh, I know all too well about the New Wage crowd's take on all this; that's especially why I lament the fact that the (supposed) scientific community gives the SHAMsters even an ounce of credibility by putting out this kind of swill. And I'm sure some of it was the reporter's spin, too, but let's face it: Nowadays there is tremendous pressure on doctors to transform themselves into celebrities (in order to attract grant money, endowments, etc.) One of the easiest ways to do that is to put out a "mainstream" message, a la our friend Dr. Oz. I just wish people would step back a bit and realize how potentially dangerous this is. Bit by bit (as our anonymous doc said above), we are eroding all of what used to be viewed as "settled science" in medicine. And we're doing it in order to win a popularity contest.

Steve Salerno said...

Or as one of my sources for SHAM put it: "Medicine isn't supposed to be a democracy. It's not end-user-driven. You don't go with the method or treatment that people want to be true, or hope to be true. You go with what the science tells you."

roger o'keefe said...

Alyssa: that was arguably my favorite song at one time.

Steve: I don't know if you help yourself publicity-wise when you crap all over a romantic holiday by again shattering people's illusions. Nonetheless I applaud you for taking a stand on common sense. Maybe if more of us try to hold the line we can actually win this battle over time?

Steve Salerno said...

Is it me or has the Blogger sign-on process gotten weirder and more complicated? Seems like there are more steps...

Anonymous said...

I still don't understand why it's so important to you to take away every single happy illusion. You must be the kind of guy who also goes around telling kids there's no Santa.

Steve Salerno said...

Anon, I could answer you at some length but I think this may suffice: Kids believe in Santa, and we indulge them (and try to make their world a nicer place) by sustaining that belief. But adults are responsible for making common-sense decisions in key areas of life.

So let me ask you this: How much faith would you have in the reasoning powers and overall leadership potential of an adult who still believed in Santa?

Cosmic Connie said...

I would love to give Anon 2:28 the benefit of the doubt and imagine that s/he was being ironic.

Steve, I didn't mean to imply that you weren't on top of the New-Wage/alt-med connection. It's obvious you are. And I agree that the celebrity-doc phenomenon (Dr. Oz, Deepak Chopra, etc.) has helped create and perpetuate the problem. However, I thought the HeartMath stuff was particularly relevant here as well. The ideas espoused by HeartMath have been promoted by Law of Attraction proponents, as in this snippet:

"A great deal of research in the United states especially at the Heart Math Institute has demonstrated when we get emotionally involved in an idea our heart emits a frequency that can be measured and actually seen that is 60 to 80 times more powerful than the frequency that your brain emits by having thoughts. So when you match up the brain frequency with the heart frequency it's a much more duplicatible process that anybody can apply in order to really start achieving their dreams and goals.

"Our planet has existed for billions of years. The universe has been around for thirteen to fifteen billion years and it functions with absolute order and perfection. Not a single electron is out of place. So we now understand that we have a universe that responds to everything we desire..."
###

The above was from an article on how to make "vision boards" work for you.
http://hubpages.com/hub/Ryan-Moats-Plolice-Video

BTW, Ron and I have experienced the same Blogger stuff you mentioned. Until recently, if we hadn't already signed into our Blogger accounts at the time we were trying to write a comment on SHAMblog or another Blogger offering, we could do so right here on the Post A Comments page. Now we are taken to a separate sign-in page. Oh, well. I got used to "New Twitter," so I guess I can cope with this. :-)

Steve Salerno said...

Con: No worries. Let's face it, there's no question that I have diversified myself away from my (presumed) core, and in the process been eclipsed by the likes of yourself and Droid, surely in some respects. I was never really a single-issue writer, though "SHAM" made it seem so, for a time. ;)

Incidentally, my verif word is "glyzoch." I like it! It should mean something (at least in Yiddish), if it doesn't already.

RevRon's Rants said...

There's no Santa???

Leave it to the Airy Fairy crowd, when logic and common sense fail (or elude) them, to revert to the tired old argument that by being truthful, you're hurting the children. Furthermore, they expect to actually be taken seriously! You just can't make this stuff up!

Steve Salerno said...

Ron, so true, that last line. I often think that you could've run large and unaltered segments of the DVD version of The Secret, say 10 years ago, and every viewer would've just assumed it was parody! "Come on! Who could take that seriously!"

Rational Thinking said...

As soon as I read this line in the article, it was clear that science was going to take a back seat:

'Until recently, the brain was considered the sole conductor of the body's symphony.'

Oh dear.

Steve Salerno said...

RT: That's an excellent point. We tend to use metaphors to express the workings of things--writers are especially guilty of this--but when we use them unthinkingly or start taking them literally, we run into problems. It is very easy to get carried away and lose touch with the nitty-gritty of reality.

Yekaterina said...

"So let me ask you this: How much faith would you have in the reasoning powers and overall leadership potential of an adult who still believed in Santa?"

This is why I love this blog.

Anyone who agrees with what Steve is expressing in the sentence above can begin to understand what atheists have to live with every single day.

I know you're not an atheist Steve, but truly, you've summed up my sentiments re: God exactly. Frustrating stuff.

Steve Salerno said...

Ykat: My crusty old heart is warmed by your enthusiasm for the blog. ;)

I may not be an atheist, but I'm not a non-atheist, either ... if that makes sense?

Cosmic Connie said...

Steve: perhaps you are a devout agnostic, as I am.

Steve Salerno said...

Connie: All I can say is that I'm devoutly uncertain of whatever I am in almost any sense, these days.