A half scald design. One day in medical school, I spilled boiling water on my foot, which instantly looked like it was going to develop a plum-sized scald. I had just finished hearing a physiology lecture on the remarkable discovery of antihistamine, and the later invention of the worldwide-popular drug Benadryl, based on this discovery.
Suddenly in my mind I thought, “This is perfect. Doesn’t a scald always involve histamine release in the skin? And the swelling and bubble blister of scalding likely are related to histamine release? Maybe I can prevent all that with this relatively recent invention.
I was excited to immediately apply this “insight” and, not knowing any better, I decided I would do an instant experiment on myself. It was a “Why not?” kind of a decision. But I knew enough about the value of a controlled study by that time, so I put the Benadryl on only one half of the scald.
And lo and behold, the next day, sure enough, the half that had the Benadryl had no swelling at all, whereas in the other, untreated half there was a beautiful half blister. It was quite astonishing to me, as it was the first controlled study I ever designed and executed! The first of many others in my life.
The inventor of Benadryl. Years later, I had the honor of giving the award lecture at a University of Cincinnati special award to Dr. George Rieveschl, the inventor of Benadryl. In my speech to the captive audience and to him , including Dr. Rieveschl, I told the story of how, thousands of miles far away in Hong Kong, I had heard the story of the dramatic discovery of antihistamine, and his later Benadryl invention, and had immediately applied the knowledge. Even though at the time there was no study that I knew of about its use in burns or scalds. I don’t think I had met Dr. Rieveschl before, and he had never heard my story. He was very amused by it, and wrote me an appreciation note. (See Photo 1.) Disappointingly, I discovered from him that apparently no one had actually followed up on my “earth-shaking discovery”. I’m still waiting for some enterprising researcher to do that!
苯海拉明的发明人。多年之后，当辛辛那提大学给苯海拉明的发明人George Rieveschl医生颁奖的时候，我很荣幸做颁奖演讲。我给包括Rieveschl医生在内的听众们讲述，我如何在千里之外的香港，听到了令人兴奋的抗组胺的发现以及随后的苯海拉明的发明故事，并且立即把这些知识应用起来，虽然我当时从未听说过苯海拉明在烫伤方面使用的相关研究。在此之前，我没有见过Rieveschl医生，他也没有听过我的故事。听完故事之后，他觉得很有意思，就给我写了一份便签表达他的赞赏 （见照片一）。遗憾的是，我从他那里得知，没人跟进过我的“惊天的发现”。我现在依然还在等待一个敢于创新的研究员来继续跟进！
Quite shocking, but then on second thought, “Why not?” If he was going to operate on others, why not on himself?! He had two eyes, so there was some kind of experimental control. He could also see with the other eye during the operation. And even if, God forbid, something went wrong, he had one backup eye! That’s why God made two.
He did what? We were all amused and awed in medical school when we read about a most famous self-experimenter, Dr. John Hunter, who inoculated himself with syphilis in order to study it! Syphilis! We thought that was outrageously bold, and I had not known of anybody with similar guts! But it made medical history for sure.
Actually, the more complicated story is that he thought he was studying gonorrhea transmission, but it turned out the pus sample he used was contaminated by syphilis. Gonorrhea or syphilis, I’m not sure either is genteel.
The Brits have Shakespeare. The medical books we read then were British, and the Brits loved to tell little stories of medical history mixed in with medicine or surgery. The stories were usually much more interesting than the medical text, and I loved to read them, often before I read the boring stuff.
You don’t really see that in American medical books, which tend to be very dry and technical. In my own writings, however, in American books on pediatric nutrition, I also tried to introduce good stories. This was quite unusual for America, but I think it did liven up the books! Although I never had a story quite as dramatic as Dr. Hunter’s.
A cowpox child. Self-or family experimentation by medical doctors actually has a long forgotten history and is probably not as horrific as it sounds! The legendary smallpox vaccine inventor, Dr. Jenner, dramatically (and safely) inoculated his family gardener’s 8-year-old son with cowpox when he was experimenting with his smallpox vaccination strategy.
It was a breakthrough success, but it was certainly a hugely bold move. If you can’t do it on yourself, at least an “extended family member” is a reasonable surrogate, I guess! I’m pretty sure no one signed official “consent for medical experimentation” legal papers then, whether family or not.
“Physician, heal thyself.” During the COVID-19 crisis, it was a bit surprising that a large number of medical health professionals did not take the vaccine when it was first available. About 50% of the entire staff at “my” children’s hospital initially declined. That does make it quite difficult to convince the general populace, when even highly respected healthcare professionals do not want to take it.
So the lesson could easily be, “physician, heal thyself”; otherwise, don’t try to heal me!” Or, to “the authorities”, please convince the hospital staff first, before imposing the vaccine on the rest of the country.
“Can I ask you a question?” Although some people think it’s not a fair question, I personally think that asking your doctor or other responsible health professional directly something like, “If it was your child, would you do x, y and z?” is a reasonable question. It’s safe to assume that if the health professional himself wouldn’t want that treatment for his own child, maybe I should reconsider the issue!
Be careful, be skeptical. Recently a family member decided to have acupuncture treatment for a very painful hip problem. She had suffered for a week, but found no relief and had to rely on pain medications. As often happens, especially if you’re Asian, she was convinced to go to an acupuncturist and, sure enough, within 12 to 24 hours she was better, and by 48 hours she was back to normal.
I’m a skeptic about acupuncture, since the scientifically controlled studies that I have read have been somewhat unconvincing. It seems many of them have benefited from the famous placebo effect where if you do something novel, it often seems to get better!
However, I’m also open-minded, so while I was impressed this time, I made a suggestion. The next time she had some problem like that, try to make it the control group and do nothing. For example, don’t have acupuncture for 2 weeks, thus going beyond the one week in her first experiment, and see if maybe it’s just the effect of time. If she can tolerate the pain. I don’t think I convinced her.
Skin options. In the last few years, mostly for fun, I experimented on a skin condition I had, called seborrheic keratosis, a kind of a black mole. Iodine is a nutrient and antiseptic. But any foreign agent used too much will often poison what it touches. What if I used it to poison my seborrheic keratosis, since I could easily dab it onto my lesions?
To my surprise, it did seem to work, especially when the lesion was just developing. However, as I tested more skin lesions, the results became weaker and weaker. Oh well, that’s why it should be studied!
Plus, I worried that with increasing doses I might poison myself, since any products even on skin might in theory gradually seep into my blood and body! Games of self-medication can indeed be dangerous.
And, for me, maybe I could even lose my medical license!? Except I don’t really have a license to lose anymore, sorry. (Recently, I sadly and officially handed in my medical license, after many decades).
The X Factor. The X Factor can be described as a variable that could have the most significant impact on outcome. Remember the fantastic healing processes in all parts of our body, to constantly heal it? Otherwise, any little injury or even little germ could literally kill us. This “God Factor” is obviously wonderful, but it is a critical X Factor which needs to be factored into any research. Otherwise, it can ruin your research.
Based on my own intense research background, I am a firm admirer of the classical “randomized controlled trial” of carefully treating half, compared with not treating the other half of any population being studied. Often considered the ultimate gold-standard study, which can help factor out any “God effect”, which in theory should be present in both groups, sort of equally.
And next time you scald yourself, just treat only half the scald!