Hypnosis in Tahrir

The man in white hair who looks like Jor-El and appears in the projected screen, just like in Superman II, is called Timothy Trujillo and he is someone who is "a Mind-Body Healing Specialist with certificates in Acupuncture, Hypnotherapy, Reiki, and Reflexology."

Reiki, Reflexology and Acupuncture are types of complementary and alternative medicines (CAM) that have no solid empirical evidence to back them. Their practitioners claim that certain power fields exist and that these therapies modify such fields. But these fields can't be measured and don't make much sense giving our current knowledge of biology and physics. Although there are papers that claim they do have an effect, very often these studies are flawed or the effect is due to the placebo effect. (I won't explain the placebo effect here, look it up, it's very interesting)

I may be biased against CAM but lets examine the evidence quickly for the sake of this blog post.

Practitioners of CAM usually resist any criticism of their methods and are unwilling to provide evidence for its effectiveness by conducting proper studies. Often the sensationalism, the grand claims by CAM practitioners and perhaps giving the patient more attention and time are the main reasons that draw the public to it.

Hypnosis is a form of an induced trance state where the subject is suggestible and relaxed. It is a real phenomenon and may have some effect but has very limited applications, not easy and doesn't work with everyone. The public perceive hypnosis as something magical or intriguing possibly due to the practice of stage hypnosis which is pure deception.

I read all the systematic reviews by the Cochrane collaboration about the studies done regarding hypnosis. I didn't find any on hypnosis in the emergency setting. But lets examine hypnosis and its use in different areas, they all described the intervetions as having limited evidence, inconclusive, sometimes less effective than counselling or that studies are methodologically flawed (uncontrolled) and small. What they all agree upon is that more research is certainly needed.

I did another search on Pubmed with the words hypnosis and emergency. I found about 20 results were about the use of hypnosis in emergency situations, most papers are opinion pieces or reviews and I could only find very few outdated studies like the one that appears on the video from 1986 (not to mention that lots of papers were behind pay-walls, which prevents the scholarly poor from appreciating the evidence for treatments and making decisions.)

But did doctors in Tahrir field hospitals offer evidence based care? Certainly, not everything. Applying pressure on a bleeding artery is something that has been taught in medical schools for centuries and is also evidence based. The bulk of what's taught in medical schools is based on evidence (but it changes and quickly, unlike CAM which is set in stone).

The volunteers in the field hospitals were incredibly brave and have set high standards of for help and attention in an incredibly traumatic and difficult situation and they did actually save lives. Which lacked in other hospitals who were upset by the flow of casualties and treated injured activists badly. However, I don't think that everything the volunteer doctors provided was actually helpful and may have caused harm.

For example, I saw overzealous doctors who would insist on suturing a small cut wound that weren't bleeding, even though their equipment weren't sterile. Administer atropine and other drugs to counter act the effect of gases, even though there was nothing solid indicating that the police was using nerve gasses. In another field hospital doctors were treating atropine poisoning (if you have time please read the excellent report by the EIPR on tear gasses used in Mohammed Mahomoud clashes).

This article in Arabic asks lots of pertinent questions. It's a critique of the practice in such hospitals and it's about time that we do so. One of the most interesting questions it asks is the lack of nurse volunteers in field hospitals.

It is also important to bring all the lessons learned from field hospitals to the health care system in Egypt and the most important one is that everyone has the right to receive equal care without any form of discrimination including one based on income.

In the heat of the moment we shouldn't forget science. Training, awareness raising and capacity building provided to doctors and volunteers is something that is most welcome, and there is much that we need to learn, but it has to be evidence based and widely accepted.

There are several countries that regulate CAM so as to protect the public. Trying to spread obscure or esoteric therapy modality like hypnosis in critical situations is worrying. Even if the organisation in that video was totally sincere, humanitarian aid ought not to be based on how big someone's heart is but on evidence.