Anti-vaccination sentiment is still spreading in our communities. People have lost faith in the authorities and in the medical field, and they are finding their own way. Unfortunately for them, the decision not to vaccinate their children will backfire.

Just this morning I read that there is a Measles outbreak ongoing in Ohio. For months now I've been reading about a resurgence of polio in New York. And of course Military personnel will no longer be required to take the Covid vaccine. The backlash against vaccination (what people perceive as an assault on bodily autonomy) will result in an increased death rate from vaccinatable diseases.

It's not an easy question, when and how to vaccinate. I don't exactly trust the official recommendations either, because I know that the guidelines are created by a council packed with representatives of Big Pharma. I am sympathetic with those who are skeptical. And I see the writing on the wall. If you don't vaccinate smartly, you are destined to be diseased.

There are a lot of anti-vax media personalities and websites that are spreading a bunch of BS. You can't believe everything you read on the internet. Of course you know that. But you also can't believe everything you read that you already agree with. If you seek "information" that supports your current position about ANYTHING, you could be allowing Confirmation Bias to steer you into a trap.

Rather than seeking supportive information, seek out the information that tries to prove your belief wrong. Test your belief. Check your understanding against what the experts say. Check your medical knowledge against the CDC, or come bounce it on me. I am not parroting anyone's sound bytes, I am a true student of medicine. I am interested in scientific studies or background information that sheds light on the hard questions.

The problem with the anti-vax craze is that a lot of the so-called "information" is coming from people who have zero science background and very little understanding of the actual risks and benefits of vaccination. Unfortunately for the anti-vaxxers, their sources are misguided and downright wrong about a lot of things. And they and their kids will suffer and die as a result.

I am always one to look for silver linings, and this particular situation has just one, which is that a reduction in the human population would be a quick way to reduce our impact on the planet. We are destroying habitat and polluting air and water at such a rate as to cause massive suffering and death in the not-so-distant future. Anti-vaxxers are offering to remove themselves and their children from the human population which will be a boon to future generations who survive diseases because their ancestors were vaccinated.

There are students working in the medicinary again. Due to covid we had no workstudy students for a couple of years. It's good to have them back, to be teaching again. And it's a heads up about all the things they just haven't been taught, don't know, don't have any way of knowing. I have a few pieces of advice that I have given to lots of ND students in the past, and I decided it's time to write them down because their shifts are shorter than ever, and we are so understaffed that we rarely have much time to talk.

There's one piece of advice that I wish someone had given me before I even started Naturopathic Medical school. This tidbit could be useful for anyone studying medicine, or really, for anyone studying something complex that they hope to be really good at. This is it: find a way to organize your knowledge, and do it persistently for your whole life.

In medicine, like in any large field of knowledge, there is more to know than any one person can. There is more than you could possibly remember. This is why there are specialists, and reference books. But an ND degree is preparation to be a primary care doctor, and in primary care, anything or anyone could walk through that door. You have to be ready. You want to do right by your patients.

To develop deep knowledge you need to approach your subject from lots of different perspectives. To practice naturopathic medicine, you need to understand the conventional approach and something about all the alternatives. You must do the work of sorting through what works, what doesn't work, and what we don't know yet. Sometimes the conventional approach is the best, and sometimes it fails. You need to know that.

But back to that tidbit of advice I wish I'd had. Start your Black Book. The Black Book is a term for whatever system you use to organize your notes about conditions and treatments. I don't know where the term black book comes from, but I do know that Wiccans write out their spells in actual black books. Farmers keep notes on their plantings and when things bloom or fruit, which is how we know that the grape harvest in Napa Valley is a whole month earlier than it was a decade ago. These days my notes are in documents stored on dropbox, accessible anywhere I can get online.

​I suggest that every student of Naturopathic medicine begin while you are in school. Ideally you'd start before you are in school, or in your first year, but most students don't because they don't know what information is important, yet. They don't know how to organize it. If this describes your situation, the next post is the How To of the Black Book. You are expected to know not only how the body/mind/spirit works, but also the conventional standard of care, and enough about a myriad of alternatives to pick the best ones for patients who don't want to do what convention dictates.

If you start while you are in school, you can use your black book as a study tool. Make black book pages relevant to whatever therapeutic targets are mentioned. Don't worry if you don't have information for every heading, just put in what you have learned. When you are preparing for yet another test, get the useful bits into your Black Book. Use the clinical board exams as another occasion to build your understanding. Study up on any conditions that you or your dear ones have, because that could well end up being your specialty. Later you will study the same way for your patients, each time one comes in the door with a new concern. Continuing Education requirements are an attempt to force even complacent doctors to update their knowledge. The practice of medicine is best done by life long learners.

The irony is rich. The term "snake oil" has come to mean everything that is fraudulent. The reference is to the infamous "snake oil salesman" who pitched and sold his wares out of the back of a wagon to the unsuspecting villagers of the American west.

Snake oil has real medicinal value. It was used as medicine before the North American continent was on the map. Centuries ago the Chinese used an oil made from a cold water snake called Enhydris chinensis to treat joint pain and bursitis. It was introduced to the US by Chinese laborers who worked on the Transcontinental Railroad in the mid 1800's. There's evidence that the ancient Egyptians used it too. In the early 1700's the English had a patent medicine made from snake oil. Snake oil was sold here as a panacea in the early 1900's, but the products sold were probably more filler and adulterant than they were actual snake oil.

So what's in it that's good for you? Snake oil, depending on the snakes used to derive it, can be a rich source of an fatty acid known as EPA, eicosapentanoic acid. EPA is used by the body to synthesize series 3 prostaglandins, which are anti-inflammatory and pain relieving. You can know EPA is important because it's in human breast milk.  EPA is effective for treating depression, improving cognitive function, autoimmune diseases including rheumatism, high cholesterol, hypertension, and more. 

EPA can be derived in the body from other fatty acids, but it's much easier to eat in your food. The richest sources are fish: herring, mackerel, salmon, trout, pilchards, menhaden and sardines. Fish do not make their own EPA. They get it from eating algae like spirulina, which we also can eat. Plant foods don't contain any EPA at all.

Part of the reason it's easier to eat EPA than to make it in your body has to do with human genetics. Some people have the gene to make the enzyme which lets them convert ALA (alpha linolenic acid) into EPA. Other people have mutations in their genes that limit their ability to do the conversion. Diabetes and some allergies also limit a person's ability to convert ALA to EPA. ALA is an essential fatty acid, meaning that no humans can make it; we have to get it from the diet.

If we don't make it very well, and we don't eat much fish, we need to get our EPA some other way to keep our cell membranes happy.  Many healthcare professionals recommend that we take fish oil.  Fish oil contains 12-18% EPA.  Salmon oil tops the list at ~18%.  Chinese water snake oil contains ~ 20% EPA, whereas rattlesnake oil is said to contain 8.5%. Cod liver oil has more DHA than EPA and is best reserved for specific uses, like building baby brains or healing brain injuries.

The reason why some snakes have more EPA than others has to do with the temperatures that they live in. Snakes and fish are both cold blooded, so they have to function with their bodies at the same temperature as their environments. Omega 3 fats like EPA don't harden in cold temperatures like omega 6s do. They help keep cell membranes flexible. Flexible membranes don't get injured as easily, and are able to function better. Cold water fish, or cold water snakes, will have more EPA than those that live in warm sunshine, like rattlesnakes.

The next time someone tells you that a treatment is "snake oil", remember this. Public attitudes and language reflect our history, not our future. Science continues to give us reason to revise belief systems, erase myths, and sometimes to welcome old treatments back into the fold.