從排毒餐談起-論中醫及另類療法的科學驗証

上星期看到台灣癌症病人出面控訴林光常排毒餐的新聞事件, 我不認識林光常,沒有看過他的書,沒聽過他的演講,也沒吃過他的排毒餐, 但看到林光常說他也要像西方醫學那樣科學驗証- 要找50個病人來証明排毒餐有效的時候, 我想問的是, 這就是科學驗証了嗎?先不論他這樣大賣排毒餐之後才說要來"科學驗証"對於消費者來說是不是一種負責任的表現, 為什麼要找50個人? 如果50個人夠証明什麼, 那30人夠不夠? 如果不夠的話,是該找100人還是1000人? 不同的病人有不同的症狀不同的嚴重程度, 要怎麼定義"有效"?

我相信林光常對這些問題沒有答案, 50個人只是他隨口說說。此文用意不在批斷林光常是否騙人詐財, 而是想提倡正確科學驗証排毒餐及其他非西醫療法的重要性。任何一個人都有權追求除了西醫"正規"醫療外的"另類療法", 例如中醫,氣功或各種生機飲食。但可惜的是大多數"另類療法"都沒有像西方醫學經過嚴格的科學驗証-一個藥該找多少病人來試? 需不需要對照組? 每個病人要追蹤多久? 什麼樣的數據才能結論藥有效? 在所謂的"正規醫療"中,這些問題都經過反覆的辯證, 一個藥才能上市。相較而言, 另類療法往往訴諸於一些抽象的道理, 以排毒理論來說- 人會生病是因為體內製造出毒素,只要吃排毒餐或是練氣功作好體內環保, 把毒排光了,身體自然健康。 聽起來很合理,我也相信無毒一身輕, 但是,什麼是體內毒素?是所謂的宿便嗎? 看的到量的到嗎? 怎麼知道毒素排出來了? 除非排毒理論的提倡者能提供這些問題的答案,排毒理論才能進行科學驗証。沒有經過科學驗証的排毒論,怎麼知道到底對疾病治療有沒有效?

姑且不論毒素量不量的到, 有些人說總之有人吃了排毒餐之後乳癌自然痊癒,沒有再復發, 這就是排毒餐有效的証明. 但是你知道到底有多少人吃過排毒餐嗎?如果100 個吃過的病人只有10個人病好了, 那到底有沒有效, 該不該吃?可悲的是病人及家屬從來就不會知道這樣的資料, 因為只有吃了有效的人會被當作神奇的例子廣為宣傳, 吃了沒效的人除了像呂小姐這樣出來控訴, 大多數人命都沒了自然默默無人知。

衛生機關一直呼籲大家不要使用沒有醫學根據的另類療法,生了病應該到醫院接受治療. 但不可否認, 醫學有限制,很多病沒有藥醫, 化療也只能延長病人壽命幾個月而已。再者化療以毒攻毒, 不只把癌細胞殺死,也把正常的好細胞殺死, 讓人痛苦的掉了半條命。另類療法對於病人及家屬來說像黑暗中的一線光, 往往一聽說有什麼秘方, 或是哪裡有什麼名大師名中醫,不管路途多遠, 不管所費多可觀, 為求一線生機, 都願意嘗試。不幸的是並非每個人試另類療法都有效, 試了一種方法沒效之後, 要不然就得回醫院, 要不然就又得在沒有科學証據下, 盲目的再瞎試瞎撞其他偏方. 很多病人就在"正規醫療"跟"另類醫療"之間擺盪. 還有人中藥也吃西藥也吃, 誰知道中藥加西藥是像1+1=2一樣會對病情加倍幫助? 還是中藥跟西藥的交互作用只會更傷身? 這些問題問西醫, 得到的答案要不是"我對中醫不了解", 要不然就是根據他們的經驗告訴你”我只看過吃中醫吃了半天最後沒效回醫院的人"。但是這難保不是一種偏差,　因為吃中藥有效的病人自然不會回醫院回診,醫師也看不到他了。問中醫呢多數也沒有答案。還有很多中醫對西醫有偏見, 恐嚇病人說會生病就是因為過去西藥吃太多傷身傷肝傷腎, 再吃西藥的話只會送命。無所適從的病人該相信誰? 很多人不僅被病痛折磨，也在各式各樣的療法中徘徊疑惑，家人對於到底該吃什麼藥爭論不休, 最後病人不要說傷神傷財, 最傷心的是連人生最後的一段路都無法平靜安寧的跟家人度過, 徒留遺憾。

如果中醫和其他另類療法都能經過科學驗証, 病人就可以有選擇的依據。哪怕只有10%的人吃排毒餐有效, 但是如果化療只有5%的人有效，那麼排毒餐就值得一試。反面來說，如果化療有30%的病人有效，那為什麼要浪費時間金錢在只有10%有效的排毒餐?　另外，排毒餐加化療會比單獨吃排毒餐或單獨化療好嗎？這些問題除非經由科學方法進行臨床試驗都不會有答案。但這樣的資訊對病人來說是一大福音。

要進行另類療法的科學驗証並不容易，最困難的地方恐怕就是找出一個大家都能信服的標準度量，讓西醫中醫或其他另類醫療都能在同一個平台上公平獲得比較。但是科學驗証對大家都有利，如果排毒餐經科學驗証有效，那麼排毒餐的提倡者自然大發利市。同理，如果中藥跟西藥能進行科學驗証齊頭比較，那麼病人可以知道到底該吃中藥還是西藥; 中醫可以消弭社會對中藥"不科學"的疑慮, 得到公正的評價, 況且科學標準放諸四海皆同, 經過科學驗証的中醫可以借此廣推全世界,救活更多人; 西醫可以告訴病人什麼時候可以中西醫併行,或是在病人藥石罔救時提供其他選擇；衛生機關有科學數據來訂定準則規範,減少民眾誤信偏方耽誤病情的社會成本。

因此, 衛生機關應輔導另類療法的科學驗証，中西醫應該放下對於彼此的成見, 合作設計一個大家有共識的臨床試驗，大眾應該盡量選擇有科學數據支持的另類療法。只有這樣,病人才有明確的資訊選擇最適合自己的醫療方式, 沒有效的偏方會被淘汰, 有效的另類療法可以救治更多的人, 這才是一個人道的現代化醫療社會。

出國記-我是台灣人,我的護照上找不到台灣兩個字

從我到美國讀書後,這些年來除了美國,台灣跟加拿大以外沒去過別的國家.這次趁著出差之便,總算有機會第一次到"外國"旅行,而且還是我們台灣稀有的邦交國-Costa Rica! 不用辦簽証唷! 滿懷興奮,到處跟朋友吹噓我要去哥斯大黎加之後,這一天終於到來.一早出門去坐飛機. 沒想到還沒出美國,在舊金山機場check in 的時候就被擋下來:
機場人員: "你不是美國人,你要去哥斯大黎加,為什麼沒有哥斯大黎加簽証?"
我: "我是台灣人,到哥斯大黎加30天內不用簽証".
機場人員:"你的護照上說你是中國人- Republic of CHINA".
我: "我是台灣人, 你說的那個中國是People's Republic CHINA".
機場人員:"你的護照上沒說你是台灣人"
我把護照拿過來翻來翻去，上面果然沒有台灣兩字，只能勉強在出生地一欄找到"台北".
我說"你看我是台北出生的"．
機場人員:"我知道，但是這也不代表你的國籍是台灣,你的護照上明明就寫中國"
還真是百口莫辯，解釋半天, 機場人員又對著他的電腦list檢查不知道幾次之後終於放行．
到了哥斯大黎加海關,又來了,海關一看我護照封面"Republic of China", 就說"CHINA? (西班牙發音,聽起來像"支那") . 我趕快搖頭說"Taiwan". 還好畢竟是我們的邦交國,護照掃瞄過後就沒問題了.
能怪誰? 台灣人自己的護照上沒寫台灣兩個字. 只見斗大的CHINA, 誰知道你是哪國人.

我記得曾經有一段時間中華民國護照上有加註TAIWAN兩字. 後來好像又取消了. 我大力支持在護照上加註台灣兩字,這跟所有國家認同議題無關,只為了澄清,我是台灣來的.

天上的星星有時就是太過年輕

最近腦海中一直浮現伍佰的一句歌詞:
"天上的星星有時就是太過年輕, 沒有光芒還在那閃爍不定"。
這句歌詞真的好有詩意,我好喜歡,還把它引用在我前一篇文章中。
伍佰的歌詞不論是國台語都寫的真的很美很棒。
但是再三吟哦後,　開始覺得有點怪怪－印象中星星應該是越年輕越亮吧？
咦，難道是我地球科學沒學好？還是伍佰天文不好?　嗯, 不是很確定...
誰來教教我...

What am I?

Recently a second generation Chinese American asked me "What is your favorite foreign country?" I said "United States, that's why I'm here". The person looked at me with a surprising face: "You have been living here so long and you haven't considered this country as home?". I'm also surprised that I've never tought about America as home, although I've considered Los Angeles as my second hometown. But anyways, how can I call this country home when I have to leave it within a month if I ever lose a job?

However, this is my 6th year in the US. It's not long enough to turn me into an American, but it's long enough to turn me into something that is not a pure Taiwanese. I seldom watched Asian TV shows nor Chinese newspapers ever since I got to the US. My favorite TV show now is "Will and Grace". This kind of lifestyle made me a person who has forgotten some traditional Asian roles. Some of the US culture has been creeping into my head unconsiously. I found it rediculous when I heard my friend in Taiwan have to leave the elevator asap when his boss comes into the same elevator. I found it dull to see all Asian faces in Taipei subway. I found it natual to see "queers" kissing each other on the streets. I found it comfotable to step into an elevator with all kinds of skin colors.

When did I change myself? I don't remember. However, I can't forget the moment when I saw the movie "Lost in Translations". It just dramatically reminded me the culture shock I had when I first arrived in the US. Now I have culture shocks when I go back to Taiwan.

Yet the 6 years in US hasn't fit me into its culture. I have no clues and no sense of participation about what the politicians in the country are doing. I have hard time speaking good English especially business English. And I still find it odd and unnatural to attend a cocktail party where people greet each other so pretentially with a "How are you? honey".

I've seen bad examples of people not adapting themselves in their immigrant countries nor picking up their original culture when they go back to their home countries. Some people ended up with social problems in either side of the two worlds. I'm so afraid that I'm gonna become some peron who is nothing, not a American, not a Taiwanese nor a Chinese. Maybe after couple years if I can still call myself a Californian, which is a mix of everything, then that might be good enough.

This post was originally finished in November, 2006.

Tired of flying

Because of relocation and beginning of a new job, I've been flying a lot this year. I think I've been making visits to the UA terminal at SFO at least once every month, starting from February 2006. I've tried almost every restaurant in that terminal-- of course none of them is good.

I have mixed feelings of all these visits at the UA terminal. The first time was my interview trip. The flight was delayed for 2 hrs, I remembered I practiced my interview talk in the airport over and over again until I felt a cold sore maturing by my mouth. That's probably the most nervous trip I've ever had. At the second time to SFO UA terminal, I've already got the offer and was on a home-finding trip. My mom was with me and we were so excited to start my new life. The third time I flew I was depressed in my personal life that I couldn't wait to get out of the city. Then I made a wonderful vacation trip and got myself back again. After that, the rest of the trips were just business trips that are all boring.
Although I'm a person who love traveling, flying so frequently starts to make me sick. Considering that you have to go to the airport so much ahead of the time of your flight departure time, the line you need to wait in for security check, the uncontrolled flight status, and the terrible food in the airport and in flight, flying is really not fun at all.

Yesterday I flew back from Seattle, because of this "Orange" security level in the airport, we went to the airport 3 hrs before the departure time. Not to mention that everyone had to check in their luggage because you couldn't even have a toothpaste in your carry-on, the waiting line to the security check was super super long that wound up to the parking lot. We waited in the line for 2.5 hrs. The FAA staff even distrubuted bottled water to everyone to keep people from dehydrating. Who has ever seen the airport security guy so nice to give you water? It's just unbelievable. My friend said if they have started to give us food then we would have been big trouble. We were lucky to get to the aiport early enough to finally (barely) make it to our flight. People who missed their flights because of stucking in the security line had to stand-by for the next (or next next) flights. So the stand-by line was also long. When I got home, I was so tired. The total amount of time I spent the whole day for the flight was 7 hrs, while the flying time was actually as short as 2 hrs.

I think I'm gonna stop flying for a little bit. Espeically not during this "orange security level". I'm sick of SFO and the smell in a airplane. The next vacation, I'm gonna drive!

PS:
The flight to Seattle was delayed for a reason that I've never heard- the first officer was missing...they had to bring someone else to replace him...


This was originally posted in my MSN space in August, 2006.

就是想寫-開格公告

很早以前就跟朋友在聊要寫佈落格，但是動機不明，又沒有同儕壓力，一直都沒有行動。
最近看了幾個朋友的佈落格,我心中不知怎麼的,就有一股想寫的衝動。開車的時候想寫, 買菜的時候想寫, 上班的時候想寫。我寫了一些放在我的MSN共享空間,但是發現MSN實在不好用,所以乾脆在這另闢天地。
最前面幾篇文章是之前放在我的MSN共享空間的舊文,以後新的文章都會寫在這裡。