Fake medical news: The black salve and the black arts

Jake clearly needed a biopsy.

When I suggested that we find out what that new growth on his cheek was, he responded with fear. “Do you really need to test it?” he asked. Then he proposed an alternative.

“I had another spot last year,” he said. “This European doctor I saw in somebody’s home put a special black salve on it, and it went away.”

“Who was this doctor?” I asked.

“At the time, I was a raw vegan,” he said. “One of our group members gave me the doctor’s name. He has a big reputation in Europe. He treated people locally in people’s living rooms.”

“Do you recall his name?” I asked him.

Jake didn’t. But I did.

Three years ago, a frightened, middle-aged woman named Josie came to see me with ugly scarring all over her face.

 

Josie’s story was similar to Jake’s: A famous European doctor. Somebody’s living room.

“He had me lie on the floor,” she recalled, “and he put on some kind of salve. It burned horribly. I was screaming in pain. He washed it off, but it still burned for a long time. This is what it left,” she said, pointing to denting and discoloration on her cheeks and upper lip. She remembered the man’s name.

It took just a few clicks to find him. He wasn’t a licensed doctor and had fled his home country ahead of fraud charges for illegal and harmful practice.

I couldn’t offer Josie much, beyond advising her to avoid getting treated on living room floors by strange practitioners with painful salves.

 

If you don’t know about the treatment Josie and Jake underwent – it’s called “escharotic treatment” – you can look it up on Wikipedia. It’s also the topic of a case study in the May issue of JAMA Dermatology (2018;154[5]:618-9).

Escharotic treatment has been around a long time. It is used for cancers of the skin and cervix, among others. The principle behind it is the same as that behind “drawing salves” (available at pharmacies and department stores), sometimes known as “the black salve.” The idea behind both is to apply something that blisters the skin and raises a scab. The eschar is supposed to draw the evil out of the body and bring cure.

Smile if you want, but this idea has been around forever and will likely outlast many treatments we now use. Fake news is old news, and does not need social media to spread (though Facebook helps).

 

Apparently ordinary people believe strange, irrational, harmful things. Why? Why on earth would Jake and Josie let somebody they don’t know put black goop that hurts like hell on their faces as they lie on a stranger’s carpet? Some thoughts:

• Fear. They think they have cancer and are afraid to find out.
• Suspicion. They don’t trust doctors.
• People they hang with tell them to. Some groups harbor a suspicious, even hostile stance toward conventional medicine, convinced that its principles are unnatural and its practitioners are more concerned with profit and prestige than with the good of their patients.

Those who hold such beliefs, like various conspiracy theorists, span the political and social spectrum, from left to right, and they’ve been around forever.

 

I don’t plan to try convincing them otherwise. No one can convince them. Citing facts and authority gets you nowhere. As Jonathan Swift said, “You cannot reason someone out of something they did not reason themselves into.”

Fake political news is a problem for society. Fake medical news can be a problem for doctors. A pediatrician confronting an antivaxer family must decide whether to try negotiating (giving their kid vaccines a little at a time) or to give up and send them elsewhere.

It takes effort for physicians to have patience with people who let unscrupulous strangers etch and mutilate their faces. As professionals, however, we doctors are obligated to care even for people we don’t like or agree with. We should therefore try to understand why people who undertake dangerous and irrational treatments think the way they do.

 

Often, what such patients mainly are is afraid. Still, the ones who actually show up in our offices are willing to at least consider medical opinion. Those who aren’t would never show up.

Jake had enough faith in me to let me calm him down enough to do the biopsy.

It was benign.

Dr. Rockoff practices dermatology in Brookline, Mass., and is a longtime contributor to Dermatology News. He serves on the clinical faculty at Tufts University, Boston, and has taught senior medical students and other trainees for 30 years. His second book, “Act Like a Doctor, Think Like a Patient,” is available at amazon.com and barnesandnoble.com. Write to him at dermnews@mdedge.com.

Jake clearly needed a biopsy.

When I suggested that we find out what that new growth on his cheek was, he responded with fear. “Do you really need to test it?” he asked. Then he proposed an alternative.

“I had another spot last year,” he said. “This European doctor I saw in somebody’s home put a special black salve on it, and it went away.”

“Who was this doctor?” I asked.

“At the time, I was a raw vegan,” he said. “One of our group members gave me the doctor’s name. He has a big reputation in Europe. He treated people locally in people’s living rooms.”

“Do you recall his name?” I asked him.

Jake didn’t. But I did.

Three years ago, a frightened, middle-aged woman named Josie came to see me with ugly scarring all over her face.

 

Josie’s story was similar to Jake’s: A famous European doctor. Somebody’s living room.

“He had me lie on the floor,” she recalled, “and he put on some kind of salve. It burned horribly. I was screaming in pain. He washed it off, but it still burned for a long time. This is what it left,” she said, pointing to denting and discoloration on her cheeks and upper lip. She remembered the man’s name.

It took just a few clicks to find him. He wasn’t a licensed doctor and had fled his home country ahead of fraud charges for illegal and harmful practice.

I couldn’t offer Josie much, beyond advising her to avoid getting treated on living room floors by strange practitioners with painful salves.

 

If you don’t know about the treatment Josie and Jake underwent – it’s called “escharotic treatment” – you can look it up on Wikipedia. It’s also the topic of a case study in the May issue of JAMA Dermatology (2018;154[5]:618-9).

Escharotic treatment has been around a long time. It is used for cancers of the skin and cervix, among others. The principle behind it is the same as that behind “drawing salves” (available at pharmacies and department stores), sometimes known as “the black salve.” The idea behind both is to apply something that blisters the skin and raises a scab. The eschar is supposed to draw the evil out of the body and bring cure.

Smile if you want, but this idea has been around forever and will likely outlast many treatments we now use. Fake news is old news, and does not need social media to spread (though Facebook helps).

 

Apparently ordinary people believe strange, irrational, harmful things. Why? Why on earth would Jake and Josie let somebody they don’t know put black goop that hurts like hell on their faces as they lie on a stranger’s carpet? Some thoughts:

• Fear. They think they have cancer and are afraid to find out.
• Suspicion. They don’t trust doctors.
• People they hang with tell them to. Some groups harbor a suspicious, even hostile stance toward conventional medicine, convinced that its principles are unnatural and its practitioners are more concerned with profit and prestige than with the good of their patients.

Those who hold such beliefs, like various conspiracy theorists, span the political and social spectrum, from left to right, and they’ve been around forever.

 

I don’t plan to try convincing them otherwise. No one can convince them. Citing facts and authority gets you nowhere. As Jonathan Swift said, “You cannot reason someone out of something they did not reason themselves into.”

Fake political news is a problem for society. Fake medical news can be a problem for doctors. A pediatrician confronting an antivaxer family must decide whether to try negotiating (giving their kid vaccines a little at a time) or to give up and send them elsewhere.

It takes effort for physicians to have patience with people who let unscrupulous strangers etch and mutilate their faces. As professionals, however, we doctors are obligated to care even for people we don’t like or agree with. We should therefore try to understand why people who undertake dangerous and irrational treatments think the way they do.

 

Often, what such patients mainly are is afraid. Still, the ones who actually show up in our offices are willing to at least consider medical opinion. Those who aren’t would never show up.

Jake had enough faith in me to let me calm him down enough to do the biopsy.

It was benign.

Dr. Rockoff practices dermatology in Brookline, Mass., and is a longtime contributor to Dermatology News. He serves on the clinical faculty at Tufts University, Boston, and has taught senior medical students and other trainees for 30 years. His second book, “Act Like a Doctor, Think Like a Patient,” is available at amazon.com and barnesandnoble.com. Write to him at dermnews@mdedge.com.

Jake clearly needed a biopsy.

When I suggested that we find out what that new growth on his cheek was, he responded with fear. “Do you really need to test it?” he asked. Then he proposed an alternative.

“I had another spot last year,” he said. “This European doctor I saw in somebody’s home put a special black salve on it, and it went away.”

“Who was this doctor?” I asked.

“At the time, I was a raw vegan,” he said. “One of our group members gave me the doctor’s name. He has a big reputation in Europe. He treated people locally in people’s living rooms.”

“Do you recall his name?” I asked him.

Jake didn’t. But I did.

Three years ago, a frightened, middle-aged woman named Josie came to see me with ugly scarring all over her face.

 

Josie’s story was similar to Jake’s: A famous European doctor. Somebody’s living room.

“He had me lie on the floor,” she recalled, “and he put on some kind of salve. It burned horribly. I was screaming in pain. He washed it off, but it still burned for a long time. This is what it left,” she said, pointing to denting and discoloration on her cheeks and upper lip. She remembered the man’s name.

It took just a few clicks to find him. He wasn’t a licensed doctor and had fled his home country ahead of fraud charges for illegal and harmful practice.

I couldn’t offer Josie much, beyond advising her to avoid getting treated on living room floors by strange practitioners with painful salves.

 

If you don’t know about the treatment Josie and Jake underwent – it’s called “escharotic treatment” – you can look it up on Wikipedia. It’s also the topic of a case study in the May issue of JAMA Dermatology (2018;154[5]:618-9).

Escharotic treatment has been around a long time. It is used for cancers of the skin and cervix, among others. The principle behind it is the same as that behind “drawing salves” (available at pharmacies and department stores), sometimes known as “the black salve.” The idea behind both is to apply something that blisters the skin and raises a scab. The eschar is supposed to draw the evil out of the body and bring cure.

Smile if you want, but this idea has been around forever and will likely outlast many treatments we now use. Fake news is old news, and does not need social media to spread (though Facebook helps).

 

Apparently ordinary people believe strange, irrational, harmful things. Why? Why on earth would Jake and Josie let somebody they don’t know put black goop that hurts like hell on their faces as they lie on a stranger’s carpet? Some thoughts:

• Fear. They think they have cancer and are afraid to find out.
• Suspicion. They don’t trust doctors.
• People they hang with tell them to. Some groups harbor a suspicious, even hostile stance toward conventional medicine, convinced that its principles are unnatural and its practitioners are more concerned with profit and prestige than with the good of their patients.

Those who hold such beliefs, like various conspiracy theorists, span the political and social spectrum, from left to right, and they’ve been around forever.

 

I don’t plan to try convincing them otherwise. No one can convince them. Citing facts and authority gets you nowhere. As Jonathan Swift said, “You cannot reason someone out of something they did not reason themselves into.”

Fake political news is a problem for society. Fake medical news can be a problem for doctors. A pediatrician confronting an antivaxer family must decide whether to try negotiating (giving their kid vaccines a little at a time) or to give up and send them elsewhere.

It takes effort for physicians to have patience with people who let unscrupulous strangers etch and mutilate their faces. As professionals, however, we doctors are obligated to care even for people we don’t like or agree with. We should therefore try to understand why people who undertake dangerous and irrational treatments think the way they do.

 

Often, what such patients mainly are is afraid. Still, the ones who actually show up in our offices are willing to at least consider medical opinion. Those who aren’t would never show up.

Jake had enough faith in me to let me calm him down enough to do the biopsy.

It was benign.

Dr. Rockoff practices dermatology in Brookline, Mass., and is a longtime contributor to Dermatology News. He serves on the clinical faculty at Tufts University, Boston, and has taught senior medical students and other trainees for 30 years. His second book, “Act Like a Doctor, Think Like a Patient,” is available at amazon.com and barnesandnoble.com. Write to him at dermnews@mdedge.com.