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Philbert also claims that there were many nephrologists saying the same sort of thing before “Noakes really got any steam behind him”. Again this is dismissive besides being untrue. There is no evidence in the published literature that “many nephrologists” were “saying this sort of thing” at the time of our first publication in 1985. How could they have since the condition was unknown at the time? And if the mechanisms were already so well understood by so many, why is it that so many avoidable deaths occurred in the US between 1993 and 2002, fully 17 years after our first publication? There is a saying that science goes through three phases: First they say that what you say is nonsense. Then they say that what you say is correct but it is irrelevant. Then they say that what you say is true but we have always known it. I appreciate Philbert’s support that we are now in the third phase of the truth of EAH and EAHC but he should be more circumspect in his descriptions of others, particularly if he is not in command of all the facts. You just never know who will show up on Slowtwitch! Thanks for joining the discussion, and sorry to be late back to the game. I lost track of this thread and just learned of your post. Though you say you will not respond to further posts (which is unfortunate, as you have a lot to contribute), I wanted to respond for the sake of the completeness of the thread.
Your point is well taken regarding the EAH in the literature. However, in this instance I was not referring to the literature. Rather, I was referring to a rather crusty internist/nephrologist I encountered during my early training, who first brought your work to my attention. I may be taking some liberties with his exact words, but his response to my questioning was along the lines of, "You know, a lot of us were discussing this before Noakes was publishing so much. Fortunately, Noakes is now making it common knowledge. You should read these papers, they will keep you from killing people." I made the (perhaps erroneous?) assumption that this was something that had been kicked around at nephrology meetings before you began publishing so widely on the subject.
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Philbert makes that error of labelling me an evangelist which is dismissive and unnecessary. The information I have presented since 1985 is based on hard evidence and is now known to be true. My understanding is that evangelists wish to force a personal belief on others, whether or not that belief is “true”. Perhaps "evangelist" is the wrong word. I did not mean to be offensive. Rather, the point I was trying to make is that you tend to argue your points rather voiciferously. For the record, while working the medical tent at a marathon a couple of years ago, I was labeled the "Sodium Nazi" by a couple of ER residents who were hot to stick large bore IV's in everyone who walked (or was carried into) the tent. I think Dev and I discussed that incident at one point...
In any case, I think I made it clear in my comments that I think your work on EAH has been a great public service, and I stand by that. In fact, a few of your papers are required reading for the medical students and residents who attend my lectures on EAH, heat illness and exercise associated collapse. They are also cited in my book, on account of which I still occasionally receive angry e-mail from coaches and athletes who explain to me the need to drink "as much as is tolerable". You can't convince some people...
Phil
Dr. Philip Skiba
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