The Fringes of Medicine

I was talking to a doctor the other day. He said something surprising.

“We aren’t able to do very much for people with persistent post-concussive symptoms.”

He wanted to know whether I’d be up for trying unconventional treatments (e.g., hyperbaric oxygen).

Everyone is different. But historically what’s worked for me is super-conventional Western medicine. I’m not down with copper bracelets or acupuncture.

But my thinking about treatment is evolving.

There are super-effective treatment protocols for some types of conditions. There’s no reason to deviate from the status quo. IV antibiotics are the gold standard for bacteremia. There’s no reason to fool around with magnets, hydroxychloroquine or raw milk.

(It’s sort of like finding the area of a circle. There’s no reason to use anything other than πr².)

But based on my experience and what this doctor conceded, doctors prescribing conventional treatments aren’t able to do a lot for people with persistent post-concussive symptoms.

I think in this context—when there isn’t a good solution offered by conventional medicine—it’s just fine to try things that may be unproven but potentially offer relief.

Treatments like hyperbaric oxygen, neuro-feedback, Vie Lights and heart rate variability training sound somewhat insane. But if there aren’t any downsides (besides time and money) it makes sense to try them.

All this raises a related question: Should the defendant in a personal injury case be saddled with the cost of treatment that’s unproven, unconventional and/or unsuccessful?

Washington law provides that if you buy the ticket (by injuring someone), you take the ride (by paying for their treatment whether it’s successful or not).

Here’s how the courts have explained it:

If the negligent actor is liable for another’s bodily injury, he is also subject to liability for any additional bodily harm resulting from normal efforts of third persons in rendering aid which the other’s injury reasonably requires, irrespective of whether such acts are done in a proper or a negligent manner…. The rationale of the rule as applied to medical treatment is that negligent or harmful medical treatment is within the scope of the risk created by the original negligent conduct.

Lindquist v. Dengel, 92 Wn.2d 257, 262, 595 P.2d 934 (1979).

If treatment for brain injury is endorsed by a physician, it seems to fall within the Lindquist rule even if it turns out to be ineffective.