The Clinicians Behind the Science

“Antibiotics don’t actually work.” My jaw dropped and I stared like a deer in the headlights. WHAT?? After all, these words had just come out of the mouth of the Chief of infectious disease. At the time we were working together in the cystic fibrosis clinic at the Children’s Hospital of Eastern Ontario. Dr. MacDonald gave me a mischievous grin and explained what she meant.

In the 1970’s clinicians such as Dr. MacDonald were treating the repetitive lung infections associated with cystic fibrosis with short-term bouts of intravenous antibiotics. The kids would come into hospital with symptoms like increased coughing and shortness of breath as well as objective tests showing diminished lung function. After about two weeks of antibiotics and physiotherapy treatment to help clear mucous from the lungs their reported symptoms improved, as did their lung function tests.

Since antibiotics are supposed to kill bacteria, the assumption was made that the medication was decreasing the concentration of bacteria in the lungs. However, when this was measured it was in fact found to be no different after two weeks of intravenous antibiotics. This is where the researchers essentially concluded that antibiotics didn’t work for treating lung infections in cystic fibrosis. The front line clinicians like Dr. MacDonald, however, insisted that they did.

Hard Evidence or Bust

The researchers came back with their conclusions supported by “hard evidence”. The clinicians told them to go back to the drawing board and find out what was really happening because there was obvious improvement in the patients.

Remarkably it wasn’t until the 1990’s that the real mechanism through which the antibiotics produced clinical improvement was revealed. It was two decades later that the role of inflammation in cystic fibrosis lung disease was discovered. As it turns out the antibiotics greatly decreased the amount of inflammation in the lungs and that had a monumental impact on lung function. It was the discovery of the importance of inflammation that led to significant advances in the treatment of this chronic disease with subsequent exponential improvements in life expectancy.

Whoops, Almost Tossed the Baby

“If the researchers hadn’t listened to the clinicians we would have thrown the baby out with the bath water,” said Dr. MacDonald with her characteristic shrug of the shoulders belied by the fire in her eyes. “All those years we just kept plugging away knowing the kids were getting better and hoping someday someone would figure out why. Thank goodness it only took two decades.”

I was reminded of this story recently when reading this news release about how researchers have discovered a new organ called the interstitium. To simplify the article, they have found physical evidence that there is a large fluid-filled space that connects us from stem to stern. There are no barriers. This is one continuous space that flows through and around every last bit of the body.

The article states, “The groundbreaking discovery of the new organ meant that old mysteries could be solved. For instance, scientists always knew that 20 per cent of body fluids was missing in a total tally, in between blood, lymph, serum and other bodily fluids. Theise says that this is found in interstitium, which totals about “10 litres of fluid” inside the human body.”

Twenty percent of body fluids have been unaccounted for all this time? In this day and age of highly advanced science, equipment that can measure the tiniest of things conceivable, and billions of dollars spent on health care research, one fifth of our body fluids have been just mysteriously missing. Well, at least they have been to the scientists.

It’s All in the Hands, not Just the Head

The thing is, those of us who work hands-on with people have always known that the whole body is connected from head to toe. How have we known this? Because we FEEL it.

We know that when one part of the body hurts, the problem lies elsewhere. We know that when we work on one part of the body we change the whole. We know that everything the body does involves FLOW.

My pet peeve is that techniques that have existed for decades that were based on this clinical knowledge have repeatedly been dismissed as “alternative” since there was no “hard science” behind them. Somehow the die-hard show-me-the-proofers couldn’t conceive that the body is connected from stem to stern despite what clinicians have been saying forever.

Well maybe now those of us who treat whole people instead of isolated body parts will finally get the recognition from the scientific community that is deserved. Not that it changes anything we have been doing or will do in the future, but perhaps we can convince the traditionalists at some point.

To Boldly Go……

Going forward I can only hope that at some point in time it will be the clinicians who inform the research and not the other way around. For as world-renowned clinicians and researchers Lorimer Moseley and David Butler put it,

“Both solid theory and risky exploration, both reasoned and imaginative interpretation, both accountability and speculation are essential for knowledge growth.”

I couldn’t have said it better myself. Now, off to do some more risky exploration of my own.

COVID Safety

Please note that three layered masks continue to be mandatory for everyone entering the clinic despite the lifting of this requirement by the Ontario government. We continue to prioritize your health by minimizing the number of people in the clinic, screening for illness, and cleaning regularly. Please contact us if you have any questions or concerns. We look forward to serving your health care needs.