Integrative and allopathic medicine: a skeptical medical student’s rant

This article is cross-posted from Subspecies, where Flora is a co-author. 

It’s no mystery that I am not a fan of CAM (complementary and alternative medicine), and not because I’m a Big Pharma Shill or been brainwashed by exhaustive campaigns by evil corporations. It’s not that I hate herbs, hate Chinese people, and hate things that are different that I don’t understand. The majority of the time I spent in a research laboratory (5 years, including time as a summer student), I spent it doing research into nutrition and functional foods. I worked with people studying the biochemical effects of exercise on health. I understand the role of preventative medicine and lifestyle interventions more than most people and I strongly advocate them. As part of, you know, medicine.

The term “allopathic medicine” was coined by Samuel Hahnemann, who contrasted it with, unsurprisingly for those of you who recognize the name, homeopathic medicine. It’s a derivative term from the Greek word allos meaning other, implying that the treatment opposes the disease, in contrast to homeos (“like”) cures. That homeopathy continues to persist 168 years after Samuel Hahnemann is a farce – that it is presented to medical students without any iota of explanation or critical thought is a tragedy. Observe:

From the AFMC (Association of Faculties of Medicine of Canada) Primer on Population Health, required reading for my class, with the offending phrases bolded by me:

Contemporary Western medicine is increasingly being challenged to consider how to respond to perspectives and treatments other than those of conventional allopathic medicine. One response has been to propose ‘integrative medicine’ as a collaboration between biomedical approaches and other healing traditions, including herbal remedies, manual interventions such as massage therapy or chiropractic, and mind-body practices such as hypnosis. Similarly, the Canadian College of Naturopathic Medicine trains naturopathic doctors who employ natural therapies as well as using the more standard medical diagnostics of allopathic medicine.

Integrative medicine is about changing the focus in medicine to one of healing rather than disease. This involves an understanding of the influences of mind, spirit, and community as well as of the body…
…Whereas allopathy implies opposing the symptoms of disease, homoepathy implies working with the disease by stimulating the body to produce its natural defensive (e.g., immune) responses.For a time during the mid-nineteenth century, homeopathy (treating like with like) was a serious rival to the allopathic approach, but the development of the germ theory gave allopathy a scientific foundation for many of its remedies. However, by the mid twentieth century disillusionment began when, despite advances in ‘the conquest of infectious disease’ hospitals remained full and waiting lists stayed long. This may have reflected a rising demand for care induced by the perception of its success, but the very success of allopathic medicine (along with improved social conditions) enabled people to live long enough to suffer degenerative diseases for which the allopathic approach is less effective. Moreover, the allopathic approach has some undesired consequences including the rapid increases in costs and the large numbers of people with iatrogenic disorders.2 While allopathic remedies are often highly effective, practitioners are also aware that the best cure may be for the patient to simply restore balance in their life and get adequate sleep, exercise, and good nutrition.

Did you spot all the devious false equivalences and straw men drawn there? Did you notice the bait and switch set up with massage therapy being touted as alternative? Integrative medicine is not a collaboration between biomedical approaches and “other healing traditions” – it’s the infusion of pseudoscience into science. There is no need to worry about traditions when designing a treatment program. You figure out what works best, and you use it. We don’t continue to give people radium for high blood pressure simply because some people in the past thought it was a nifty neat-o idea! Notice also the mention of naturopaths as if they were an equivalent but separate kind of doctor, as if drinking powdered deer horn tea had the same level of efficacy as prescribing a statin.

The idea that “allopathic” medicine is focused on disease rather than healing is a ridiculous notion that I am ashamed to see presented by the people who are overseeing the curricula of this country’s medical schools. In my first week here, the concepts of the spectrum from health to disease, the need for population-based intervention, and the need to treat patients as individuals and not diseases has already come up. We’ve also already talked about treatment – but what is the point of talking about treatment if you don’t understand the disease? I mean, it’s all well and good that Mrs. Johnson comes in vomiting blood all over, but I’m pretty sure that thinking hard about being healthy and taking a nap isn’t going to prevent her form going into hemorrhagic shock! Only once you understand the disease can  you design a treatment. If you think her vomiting blood is from possession by an evil forest spirit, you’re going to proceed quite a bit differently than if you realize that Mrs. Johnson has a ruptured blood vessel in her stomach. The whole purpose of medicine is to achieve wellness! No amount of pre-scientific thinking or feel-good nonsense is going to save Mrs. Johnson’s life!

And of course, the criticisms that because “allopathic” medicine works so well, now people are living long enough to deal with issues that it can’t treat. So, when Mr. Wong comes into your clinic, presenting with symptoms of Alzheimer’s, clearly the only answer is to abandon the system that works really well at everything else, and try some random stuff that has no evidence to support it. This is the same sort of tactic that creationists use in the “God of the gaps” arguments. We don’t know, so God did it. We don’t know, so let’s use reiki. The absence of evidence for something does not mean you get to fill in the blanks with your chosen brand of unsupported beliefs. If there is a gap in our knowledge about what to do with an Alzheimer’s patient, we should research into causes (and subsequently treatments) of Alzheimer’s disease. Plausible, mechanism-based treatments. They don’t need to be drugs; there’s been psychological-behavioural research being done into mental training exercises (most of which has come up short in translating to increased everyday functionality.) Maybe we need to do more to prevent head trauma injures like concussions during sports activities. Maybe we should look at how alcohol and drug abuse can lead to dementia later in life. All of these are well within the realm of medicine, and require no magical thinking. They are testable hypotheses and should be pursued. Until we have an answer, you don’t get to fill the gaps with the nonsense du jour.

Did you also notice that homeopathy is given a one-off vaguely plausible sounding mechanism without any sort of definition as to what it might be? They make it sound like homeopathy is like vaccination, dealing with it not only credulously but dishonestly. How many students are going to read that claim, assume it correct, and go on to think that is is a perfectly legitimate form of medicine?

It’s unsurprising that they also bring up iatrogenic diseases, which can be literally translated to mean “healer-caused” diseases. These diseases range from anemia due to excessive blood draws in the hospital, to hospital-aquired (nosocomial) infections, to potentially lethal drug side effects. They are a major issue in medicine, especially when they are preventable, as in nosocomial infections (which can be prevented by proper cleanliness techniques) or worse, when someone screws up. There are failsafes in place for mistakes, and are why hospitals have adopted a team approach, but they inevitably will happen. However, this is not an argument for throwing the whole system, which we’ve already established works quite well. This is an argument for making the system better, for preventing the mistakes, for increasing communication within a team, for finding more failsafe systems, for being pro-active. The system isn’t broken, it’s just not perfect. You shouldn’t replace something that works but has side effects with something that doesn’t work but has none, especially since the lack of side effects are due to the fact that it doesn’t work. 

This is, of course, also assuming that “traditional” medicine has no side effects, which the anti-vaccine crowd has shown us that it can have. Eschewing modern medicine kills people. If people forsake their family physician for a naturopath, they will cannot be given prescriptions if they need them. If Mr. Sullivan is an overweight, 58-year old pencil pusher with genetic high cholesterol and an impending heart attack, then advocating a healthy diet and more exercise is important. But given his genetic preponderance and his previously sedentary lifestyle, no amount of oatmeal will help. In addition to lifestyle counselling, he desperately needs pharmaceutical intervention, possibly stenting to keep his heart’s blood vessels open, and an intensive monitoring of his blood lipids. If he dies of that heart attack, and the naturopath did not refer him to a physician when first line defences fail, that naturopath is responsible for his death. Just as letting someone get hit by a bus because you don’t want to rumple their suit jacket makes your failure to act lethal, so does dependence on pre-scientific thinking while avoiding science-based medicine cause people to die. Naturopathy, at its core, is based on true principles (that we get drugs from the natural world, there’s a science based on it called pharmacognosy), but in practice is little more than hand-waving, placebo-effecting ridiculousness. On the Canadian Association for Naturopathic Doctors, the website linked to by the AFMC’s primer, they recommend for colds & flus:

To aid the elimination of toxins through the skin induce perspiration by taking long hot baths, using an infra-red sauna or steam room. Increasing perspiration through the skin is one of the safest and most effective ways of eliminating toxins.

You know, unless you get dehydrated and die.  I hear that making people who have a fever sweat even more is really sound medical advice. To get rid of toxins. Right.

So no, Association for the Faculties of Medicine of Canada, I don’t think that we should consider integrative medicine and the “treatment of mind, body and spirit” in our practice. A doctor is not a shaman, nor should they attempt to be. I think physicians should be compassionate, caring, understanding, attentive, and open with their patients. They should be concerned for their patient’s autonomy, their mental health, and their feelings. They should strive to give them the best care, based on the best evidence available.

TL;DNR: I don’t think that there is any room, when people’s lives are at stake, for bullshit.

Cosmos II: Electric Boogaloo!

Cross-posted from Startled Disbelief.

Good news, everyone!

Fox has just greenlit a 13-part sequel to Carl Sagan’s phenomenal Cosmos: A Personal Journey, called Cosmos: A Space-Time Odyssey.

Sagan’s original collaborators, Ann Druyan and Steven Soter, are involved in the production, and the series will be hosted by the only person who could possibly hope to fill Sagan’s shoes: renowned astrophysicist and all around dream-boat Neil deGrasse Tyson.

Here’s the weird bit, though: it will be produced by Family Guy creator Seth MacFarlane.

At least, I thought it was weird until I read this:

“Never more than at this moment in the modern era have we needed a profound reminder of the colossally important and exciting role that science, space exploration and the human quest for knowledge must continue to play in our development as a species,” MacFarlane said. “We should be vigorously exploring the solar system by now, and who better to inspire us to get there than Ann Druyan, Steven Soter, Neil deGrasse Tyson and, of course, Carl Sagan.”

This is excellent, excellent news!

Artificial Dissemination

At a social event with the Winnipeg Skeptics this week we ended up talking about religious people and the religious right among other things. We were marveling at how some of the Republicans in the U.S. can be so far off the deep-end with their beliefs. It reminded me of an article I’d read a couple months ago, for which the connection may not be immediately obvious. Hopefully I can explain.

In my personal obsession with psychology and sociology I’ve tried to understand how people think and why they do what they do. This article describes how we tend to operate by personality archetypes (specifically those relating to gender) and how they affect the way we think about ourselves; and by extension, how we think about others. The focus of this article is arguing against the idea of gender based essentialism, and that most of how we behave is according to how we think about ourselves and is passed on socially. I don’t at all want to undermine the profound revelations to be made on just this issue, but I think that these findings also have vast implications for every arena of our lives.

During that discussion with the Skeptics I was reminded a family member, which I related to the group. I explained how she identifies as a conservative and repeats many of the standard truisms that go with that, yet when I asked to explain her views she actually breaks to the left. How could this be? Most of the extended family is conservative, her local community is very conservative, and lives with a staunchly conservative partner. She even votes conservative! Why is there such a mismatch in her views versus her identity?

Like the subjects in the article above, I believe that most people adopt cookie-cutter identities in an attempt to fit in with their social circles. This is something we do in many aspects of our lives, and not just with gender or sexual identity. We do it with our politics, our jobs,  in our romantic relationships, with our families and friends, and with our children. In essence, we wear many different hats. It’s a basic mechanic of social grouping and we apply it to almost everything. With it we sometimes even adopt beliefs that are not our own, though we may wear them loosely.

Now, moving further towards the point embedded in the title: we don’t just do this to ourselves. We do it to others. Often, we do it oppressively. We repeat little truisms about other groups. We make presumptions about who other people are without actually knowing, based on nothing more than a projected and/or perceived group identity. We reinforce our position within some groups by advertising how we treat other groups. Other times it’s simply and subtly implied in our choice of words or the tone of our voice. In all these ways we project on others our subliminal (or overt) message about who they are (especially in comparison to us), and what we think their value and purpose are.

Side-note:
Whenever harsh words like oppression or privilege are used, I think there is something embedded in our neuro-linguistic vocabulary that implies ill-intent. Let me say it explicitly: bad intentions are not required to create oppression. For us it may just be learned patterns and we may not even know the message that we are conveying! As such, sometimes all that is required is ignorance (lack of specific knowledge, not to be confused with stupidity). Language is full of traps like this.

When we operate within the world-view and norms of our social group without bad intentions, and someone comes up to us and tells us that we’re oppressing them with our words and actions, it’s easy to think of them as being deluded. After all, what they’re saying is completely outside of what we know to be normal, natural and obviously true. We know our intentions are good (or at least not intentionally malicious), so obviously they are full of it, right? I mean, it’s not hard to believe. We have so many daily examples of people complaining about things that don’t make any sense to us and some who are indeed obviously deluded.

No political correctness

Image via Wikipedia

Here is the birthplace of the concept of “Political Correctness”, where the hidden motif of that other person is to stifle our very being, and sanitize all of existence into rainbows and kittens and everything nice. The belief that their group thinks that way in comparison to ours fits well with our understanding of how things are and they just confirmed it for us. More importantly, they’re in our face telling us we’re bad, and we feel threatened! We need to make it stop, and stop now! Our emotions appeal to our little problem solver upstairs, and it gives us an answer that makes the bad feeling go away.

But why?

Millions of years of evolution have given us this handy fight-or-flight mechanism to protect us from threats, both to our body and to our carefully nurtured, albeit tenuous sense of self. But as we ought to know, evolution is not perfect. Especially when in just a few short years (historically speaking) our world has gone from small communities and tribes with similar values and identities to a global society of remarkable complexity and conflicting values. It’s no surprise that our instincts could misfire. What’s really going on is usually more complex than whatever scenario our brain comes up with in half a second and with almost no meaningful information.

We feel more than we think.

The problem is that many of our socially absorbed views and behaviours are demonstrably false and counter-productive to our proclaimed goals. On the whole, we don’t think to find the truth. We rationalize to preserve our identity. Without deliberate investigation into ourselves and our world, and decoupling from these pre-canned identities (or at least being aware of and working around them), we will continue flying blindly on autopilot, and our greater issues will never be solved.

Won’t evolution fix everything eventually?

Evolution is just the explanation of how we got here. It doesn’t magically give us what we want. It doesn’t deal with our wishes for happiness or camaraderie. It doesn’t deal with things working optimally at all. It is merely “survival of the good enough.”

However, we have a brain that is capable not only of rational thought, but also of deep introspection. We have it because it was the advantage we needed to survive. We can leave our future to the magic of death and suffering to select some better genes, or we can use the tools we have proactively and figure out how to get what we want through greater awareness. Our evolution has not yet brought us to fully rational thinking or conscious social function and as the social world continues expanding through advances in social technology, the pressure to get there will also increase.

So I ask you now, who are you? And more importantly:

Who do you want to be?

Cross-posted from Jack-in-the-Brain

Deconversion

This isn’t my story—I don’t really have a deconversion story. The following is a guest post from Tim Herd, a fellow software developer and member of the Winnipeg Skeptics. Tim, an avid redditor, can be found online at The Flagcarrier. This entry is cross-posted from his blog.


“It is they who see this charade for what it is and join in the pageantry who are to blame.”

—Wiegraf Folles

Today I attended the monthly “Drinking Skeptically” meeting from our local skeptics association. I’ve been skipping it, but I thought I’d go tonight on account of it would help with my being-antisocial problem.

At one point, the topic of Christian upbringings came up. It seems that most of our members were either raised secularly, or given some meaningless wishy-washy version of Christianity that might as well not have been. Maybe not atheism per se, but secularism was the default for them. But not for me. After going through my story a bit, I’ve realized that I would really like a canonical record I can point people to, so I don’t have to keep telling the story and accidentally changing it every time. So, here goes.


First, my background. I was raised, as far as faith is concerned, by a Mennonite mother and a homebrew-protestant father. For those of you unaware, Mennonites are an anabaptist branch of protestantism. Due to 500 years of living in reclusive colonies, they are also effectively their own cultural group. Imagine Ukranians, that speak German, and are devoutly religious, but not in your face about it at all. That is Mennonites. They have a fairly agreeable doctrine, it’s very traditional but not conservative so to speak. They are also pretty progressive. They have great social services they provide, and in general with them it is always help first, proselytize second. All things considered, they are generally a fairly good version of christianity. Obviously though, I still have some disagreements.

My stepdad’s homegrown protestantism, on the other hand, was different. It was a very serious thing, for one. He was of a fundamentalist mindset, but in a very different way. Where most fundamentalists in the States, for instance, look at the physical descriptions in the Bible as literal truth, my stepdad never did. The earth was probably billions of years old, but who cares. If the scientists tell us evolution happened, then God did it. But the moral precepts in the Bible were taken extremely literally. These are the rules. You have to follow them. You have to like them. If you don’t, Hell.

Growing up, I took my “faith” extremely seriously (up until my story here begins, anyway). After all, one wrong move and I’m burning in Hell forever, and that’s a long time. This fucked me up royally. I never had youthful indiscretions. To do that would be a sin. You always hear about the “straight edge” kids. The kids at church private schools who look all prim and proper, and then go lesbian experiment with their first-cousins, drink at 14, sell cocaine, sleep with their youth pastor (all true stories of people I personally know, btw). I was never like that. I never drank. I never smoked. I never even SAW a drug. I never kissed a girl, because what if she’s not religious enough. I never shoplifted. I never lied. I never disobeyed my parents, in any significant way. Because to do that, would be hell.

A lot of people have a strong emotional connection to their religion. I never did. To me, it was quite simple, cut and dry. This book is true. It says I have to do X. Therefore, I’m doing X. No emotional connection required. Part of this was my natural tendencies; I am a computer programmer, and prone to both literal, and critical/rational thinking. But part of this was my parents. You see, my stepdad also took religion very seriously. To him, an emotional connection to religion was evil. After all, if you’re having an emotional connection to, say, the church hymn, you’re gratifying yourself instead of worshipping Jesus. We actually switched churches, three times, and finally ended up no longer attending, because the congregations treated it too much like a social outing, and not enough like the very real threat of hellfire it was.

Because this was a very serious thing to me, I read the entire Bible, cover to cover. Not cherry-picking verses like they like to do, but like an actual book, starting at the front and ending at the back. Unlike almost every other theist-turned-skeptic I know, I was not shocked by the Bible’s insanity. To me, that made no sense. The Bible DEFINED sane, so if I didn’t agree with it, I was wrong. But this had an important effect on me nonetheless.

Remember Mennonites? The specific part of the specific city I live in has one of the highest concentration of Mennonites in the world. There were 12 Mennonite churches within walking distance of my house. A large number of my peers at school were Mennonite. And some of them were really religious. As I started to get close to some of them, I noticed something. None of them were nearly as serious about it as I was. And, well, I considered myself to be doing just the bare minimum to get by. Some of the more openly pious ones (reminiscent of that story about the pharisees praying outside) would not even associate with me, because I “wasn’t religious enough”; I didn’t attend their youth groups with them. To me, their youth groups were nothing but an excuse to socialize, while simultaneously being arrogant and holier-than-thou because they filled their weekly church quota. I would talk to some of these more pious peers, and find out that their Biblical literacy was pathetic. Some didn’t even own a Bible. None of them knew what it said. They all violated the commandments within the Bible daily, and they didn’t even think this was a big deal. In my indoctrinated mind, not taking the Bible seriously was like condemning yourself to Hell with no chance of being saved. And that all these people, including the “most religious” friends I had, acting like it was no big deal? The dissonance was disturbing.

For a while, I could convince myself that those people were just “not true Christians”. The persecution complex that the Bible advocates played well. Obviously, in a church of say 1000 people, there may only be 20 “true Christians”. This was, after all, the rhetoric that my parents preached in our “homechurching” every Sunday, so it made perfect sense. While this is complete bullshit, I believed it right around age 15-17, at the perfect time to ensure I would be socially retarded forever and alienate all the people who could otherwise still be my friends. But I couldn’t believe this forever. Two main things contributed to this.

The first thing was that I sung in the church choir. At the time, we attended a small community church, populated mostly by the elderly. So, the church choir was made up of two main groups of people: The Elderly, and The Preacher’s Family. I assumed, naievely, that the pastor’s family would be of higher theological calibre than other church attendees. But what I saw contradicted this. The preacher and his family, as far as I could tell, sung in the choir simply because, well, that was expected. Where my stepdad had me convinced that I needed to sing to prove that I loved Jesus, the preacher’s family was singing because “what would they think if they saw the preacher’s family not in the choir?”. The internal politics of church life, the putting up images, the constant judging everyone elses’ piety. This was all so strongly distasteful to me that I started to doubt my faith. After all, as far as I knew, the consequences of infidelity was Hell. And the preacher’s family of all people didn’t even take this seriously. Maybe I shouldn’t either.

The second thing that happened, not to get too stereotypical, was science. I took science classes. In biology, I learned about evolution. Natural selection. Common ancestors. I learned that a literal creation was unnecessary. I had never been anti-science. I always acknowledged evolution as being at least somewhat meritous, because why else would they all believe it. But seeing just how thoroughly worked out the science was was a bit of a shock. In physics, I learned about the beauty and simplicity of the laws that governed the world. Before taking gr 11/12 physics, I fully believed that God can and did invoke miracles on a regular basis. After learning the science, I realized that miracles were impossible.

And so, having had my previous worldview shaken thoroughly, I started investigating. I looked up Christian apologetics and tried to convert my long time atheist best friend. But looking up the best arguments that Christians had come up with, having 2000 years to prepare, I found them laughable. Filled with fallacy and appeals to ignorance. This is the best they can come up with, I thought. It was pathetic.

At this point, I was prepared to stop calling myself a Christian. I read over the Mennonite Confession of Faith, and realized that I didn’t agree with any of it. I looked at the “Christians” I knew and saw them as mindless sheep, brainlessly parroting whatever snappy catchphrase they had heard the previous Sunday. I looked at my parents and it occurred to me just how many things they did, that maybe they shouldn’t’ve, but that were justified by their faith. I realized that it would simply be dishonest to call myself a Christian. Instead, I latched onto the concept of Deism. There is a God, but he is clearly not the Christian one, and he is clearly not fucking with the universe. Ever. At this point I was just turning 18

Although I didn’t really believe anyone was listening, at this point I started praying, every night, for the truth. “I don’t know what to believe, God, but I know that what I was taught growing up is a lie. I’m afraid of what I might find out, but I have to know the truth. Please, if you’re out there, show me a sign”. This, every night, for a year. No sign.

When I started university, I got exposed to other viewpoints. In engineering, pretty much everyone was default-atheist. And in computer engineering, everyone was very smart, and thoughtful. Many deep philosophical discussions were had. I saw firsthand just how ridiculous the campus religious groups were, meanwhile I found out that all these godless heathens were actually pretty cool guys. Ehty killed aliens and wasn’t afraid of anything. At this point, I had a bit of a philosophical realization. A universe in which a god exists, but does not interact in any way, shape or form (ie a Deist universe) is indistinguishable from an atheistic universe. They are the same thing. And so once again, I ‘converted’ simply by deciding to be honest about myself. I was an atheist.

Around this time, I had also discovered the atheist haunts on the internet. Places like r/atheism. People like Dawkins and Dennett, Harris and Hitchens. Wikipedia articles on philosophical beliefs. The books Gödel, Escher, Bach and I Am A Strange Loop, which had a very strange, almost spiritual effect on me. I learned about computation theory, AI, theories of mind, all of which served to demystify. To fill some of the gaps that God was hiding in.

All of these resources, combined, had a strong effect on me. But the ONE thing that really gave me that ‘deconversion’ moment was this video, The Instruction Manual For Life. When I saw that piece, I cried. (Ed. note: I just watched it again. I cried again. The last time I cried was in January, upon watching the end of MGS4). It was like the author had lived my life. He verbalized all of my exeriences, all of my thoughts, my fears. In eight minutes of animation. I immediately watched all the other videos uploaded by the two authors of the video, and forevermore it stuck with me.

Now, I am an atheist. I am also a strong skeptic, something much closer to my fundamental nature. I apply my critical thinking across the board. I like to say that my skepticism is axiomatic to my personality, and my atheism is derived from that. In a certain academic sense, this is true. But in a stronger, more emotional, more personal sense, there is more to it. I have personally seen the damage that religion can do. I have never suffered physically due to religion. There are kids who are beaten in the name of God. There are kids who are homeless because their pious parents cannot abide a homosexual in their houses. Hell, think of all the people who are not alive today, thanks to religion. But one thing I have experienced is the thought-supressing effects of faith. My whole life, I was taught to believe a certain thing. To expect a certain thing from the universe. To work towards a certain goal. And then one day I realized I had been lied to, systematically.

Religions both allows and encourages restricting the thoughts of yourself and others. And I can think of nothing more abhorrent. There were times when I personally questioned my own sanity. Everyone else believes this, yet it is so obviously wrong. How can they all be so blind? What if I’m the one who’s wrong. But that’s impossible, see right here this can’t be. But they all say it is. How could I possibly be right here.

And so this is why I am now, finally, at age 21, an anti-theist. Nobody should be forced to think a certain thing. Nobody should be forced to question their own sanity as a result. It is as simple as that.


Thanks for sharing your story, Tim.