A mom was en route to my office. Her 5-year old child in the back seat was unresponsive. She was on the phone with our receptionist. She reported her kid could barely speak and was ghost white.
Speaking through the receptionist, I insisted the mom drive straight to the emergency room. But the mom insisted on seeing me.
When mom arrived, the child hung limply in her arms. The kid’s appearance was the classic presentation of a floppy child: unable to lift the head, eyes closed, hypotonic muscles, and insensitive to stimuli. The little one was markedly pale and thin. The kid needed emergency care from a medical doctor, not a naturopath.
We entered my office, and the mom’s friend sat in the waiting area. Mom launched into a detailed health history. This family did not use conventional medical care. Mom gave birth to numerous children at home with a lay midwife. None had been vaccinated. None saw medical doctors. Illnesses were treated with raw foods, fasting, hydrotherapy, herbs, and “detox” concoctions.
Against the father’s wishes, mom had brought the child to see me, the most “integrative” type doctor she could find, and she drove for five hours.
Her kid had not eaten for days. According to mom, the child had only wanted to drink powdered herbs mixed in water since falling ill. Malnutrition was obvious. But something else seemed grave.
I completed a physical exam of the child, while listening to mom anxiously describe the events that led her to me. I noted a low-grade fever, bruising, and pale conjunctiva. At the start of an abdominal exam, the child moaned and writhed. I wasn’t able to get far.
I explained to mom that her child needed emergency care, but she didn’t get it. My alarm bells were ringing, but I had to tread carefully given her family’s alternative lifestyle and her frantic demeanor. I worried I could scare her away, while at the same time I worried about leukemia.
I gently broached the subject of anemia which led mom to ask about blood transfusions with immense fear. She was against them.
I repeated: the kid needed to be taken to the hospital.
Mom then started to negotiate: What tests would the hospital order? Could I order these tests here? What could a medical doctor do that I cannot? Why was I so concerned?
Her fear began to break me. I wondered, maybe I could order the labs here and start the diagnosis process. No way.
She pleaded, “Before you make us go to the ER, would you talk to our naturopath back home?”
“Oh? You have a naturopath back home?”
“Yes! She has been our family doctor for years. She makes house calls. We love her.”
“Sure.” I stepped out of the room to call the other naturopath.
Naturopathic doctor: not a doctor
The conversation I had with this naturopath was frightening.
Her naturopath asked, “What you do think about the gallbladder?”
I was confused. “I am not sure what you mean.”
“Well,” the naturopath explained, “The gallbladder can cause symptoms like this. Maybe a gallbladder cleanse is needed.”
I became furious and all decorum dissolved. “No, this is a not a gallbladder issue. The child is anemic and may very well have leukemia.”
Instead of going back into the patient room, I sought the advice of another naturopath in the office–a cancer “expert.” This naturopath, I thought, would help me navigate mom’s fears and the impending hospital referral.
I was wrong. The advice was indolent. My questions were more or less regarded as rhetorical. There was no return to my urgency. There was no solid advice from someone who had been in practice for over 15 years. I walked away empty handed and deflated.
I took a deep breath and entered the patient room. “Your child is very sick,” I said. “The best option, the fastest option, and smartest option, is to bring your child to the emergency room and let them handle this situation. This is what I would do if I were you.”
Mom started to bawl. “We came to you to avoid the hospital!”
“Yes, I know. But I would not insist that you go to the hospital if I did not believe this was a life or death situation, and that the best medical care possible will be provided to you in the emergency room.”
Mom got her friend from the waiting area. The friend encouraged her, took the driving directions from me, and packed up. As the they walked out the door, I jumped on the phone to contact the emergency room to speak to the hem-oncologist.
Based on my description, the hem-oncologist immediately suspected leukemia. The child was admitted to the hospital that night and formally diagnosed a few days later after a bone marrow biopsy.
I remained in contact with this family for several months. Mom did not trust the hospital, the nurses, or the doctors. Mom would call me almost daily to consult. Eventually, the medical doctors caught wind of this and began calling me directly. They were utterly floored to learn that I supported all of their medical recommendations.
The hem-oncologist was particularly happy to speak to me. In her experience with naturopaths, she often found herself fighting their recommendations and treatments for cancer. She asked if I would be willing to come into the hospital and have a “roundtable” discussion with the family and medical team. I agreed. We hoped this would open lines of communication and re-iterate to the family that we are all trying to save a life.
The next week, however, the oncologist cancelled. The family decided to transfer to another hospital a few hours away.
I am still not sure exactly what happened. It took me some time in get in contact with the mom again. She was either very busy caring for her sick child, avoiding me, or both. When we finally talked, she made several vague comments about the father not wanting to pursue chemotherapy and wanting more opinions. I offered to drive to them and meet the oncologists. Mom declined. She was interested in speaking to my colleague, the naturopathic cancer expert, regarding therapies for leukemia. Yes, the same expert who couldn’t give me straight answers on what to do when the family first saw me in our clinic.
The road to recovery
Typically, the 5 year survival rate for acute lymphoblastic leukemia is quite good with conventional treatment. The last statistic I read was around 85%. I suspect the 5 year survival rate without chemotherapy is not so high.
I was listed as the child’s primary care doctor for awhile and would occasionally receive faxed updates from the new oncologist. Every report would end with statements about the parents refusing aspects of care. Mom eventually stopped returning my calls.
I think about this child all the time. I think about the obvious cancer presentation and how the other naturopath totally missed it. I think about mom’s emotional reaction and how this impacted my decision-making. I wonder what would have happened if the family sought care from their naturopath back home. What would have happened if they first saw my naturopathic cancer specialist colleague? Would the child have ended up on a gallbladder cleanse or intravenous mistletoe? Bleak outcomes would seem likely.
Sadly, this child was just the first gravely ill patient to come through my clinic’s door since I started there. Many were very confused into thinking naturopathic treatment for cancer is efficacious, and I witnessed many further misled into really whacky therapies. All were desperately looking for answers and guidance. All were scared and willing to try anything to save their lives, except, in many cases, surgery, chemotherapy, or radiation. Conventional treatments were generally shunned.
I know from Edzard Ernst that the use of alternative medicine in cancer patients is positively correlated with shorter life spans compared to patients who did not use complementary/alternative medicine. I fear the reasons for this correlation is that alternative medicine causes direct harm to cancer patients or directly interferes with conventional treatments. I agree with Ernst that the reason for the correlation is likely a combination of factors.
Do not Choose Naturopathic Cancer Treatment
One day while I was injecting vitamin C into a cancer patient as an adjunct to chemotherapy, the patient looked at me with tears and said, “I bet you think I am weak for choosing to use chemo.”
I replied, with all honesty, “I would do exactly the same thing as you. I would do whatever it takes to stay alive.”
Today my answer is different. I would do whatever it takes to stay alive, which means totally avoiding naturopathic medicine.