Putting Dr. Zamboni on Ice

So . . . a doctor named Paolo Zamboni has been trying for some time to get people to think differently about multiple sclerosis. MS has been long perceived to be an auto-immune disorder that causes degeneration of the nerve endings, which in turn causes a wide variety of symptoms, and eventually physical and mental disability. Dr. Zamboni wants to begin trials in Canada, lots of MS patients want to undergo the surgery, but the Canadian government has decided not to fund the trials.

Ok, that was kind of dry and probably not what you have come to expect from my blog entries. But it does relate - because it may come down the same type of errors in thinking that I'm so fond of writing about. I hedge my claim because I am not a medical doctor, and cannot assess the merit of the medical claims of Dr. Zamboni; I can only speak to the decision-making biases that surround his ideas.

Essentially what is going is that someone is trying to help people with MS, and the way in which he is trying to do it is different the accepted conceptualization of the disease. Dr. Zamboni is claiming that MS is caused by iron build-up in the brain due to vein blockages, and therefore treatable with angioplasty (surgery in which veins are opened up). Data regarding this new procedure is mixed but apparently there is evidence that it can work.

This all reminds me of the story of Heliobacter Pylori. Once upon a time, doctors all knew that peptic ulcers were caused by stress, diet, or blood type. Two Australian doctors, Barry Marshall and Robin Warren, came up with a crazy idea - ulcers were caused by bacteria. All the other doctors laughed at them; silly people thinking bacteria could cause ulcers. To prove them wrong, Barry Marshall drank a beaker full of H. Pylori bacteria (sort of like Sam Beckett proving that his theories of time travel were correct on Quantum Leap). Lo and behold, Marshall developed ulcers, that he then treated with antibiotics. Despite this (and other) proof, the medical establishment took a long time to accept this new idea regarding ulcers. And then they did, and everyone lived happily ever after, especially Drs. Marshall and Warren, who won Nobel Prizes.

Is Dr. Zamboni the next Marshall and Warren? I don't know, and the point is that no one does (he does share one similarity - while he didn't do the procedure on himself, he did do it on his wife, to apparent success). He has a method that has worked. There is risk involved (as with any procedure), but as long as the people willing to undergo the trials are aware of the risks, they should be allowed to volunteer themselves. The sense around the government's decision is that it was driven less by budget and more by dogma - MS is an autoimmune disorder, so why look for other causes? Prominent doctors are applauding the no-fund decision.

(I also think that if Dr. Zamboni had a different name, people might be more accepting of his ideas, especially in our hockey-mad country. Unfortunate but probably true)

The point is that it can be difficult to accept new ways of looking at old problems. Evolutionarily, this makes sense; the existing system works ok, and new ideas can be dangerous, so let's be biased against new ideas. The problem with this is that a few new ideas are improvements, and impediments to the acceptance are harmful in the long-term. The costs here are not huge, and no one is being coerced into anything. Just pony up the dough and lets see if we can help people.