Over and over again, they told her that she was being silly. But Gemma was convinced that her doctors were mistaken. You just know, don’t you, when something is wrong, when the sensed systems inside your body nudge from their alignments. Strange shapes and colours would waft and form in her vision. She would fall asleep on the sofa and nobody could wake her. She was having difficulties in the office – her managers kept insisting they had told her what to do, but she had no memory whatsoever of them doing so. They had begun to treat her as if she was stupid. Gemma was not stupid. She had qualifications. A degree. But she didn’t feel very clever when she sat in that chair in her doctor’s surgery, desperate for him to listen. Every time she went, he would say the same thing. There is nothing whatsoever to worry about. You’re just a young girl, being silly.
They found six small tumours, the size of thumbnails, on her brain. Oh, it’s nothing too serious, they said. They’re benign. Some people live with these kinds of things for the whole of their lives without a problem. But Gemma knew her own body. She knew her own mind. She knew that she was not the sort of person to sleep through her radio alarm clock, to courier files to the wrong office, to forget where she had parked her car. You’re panicking, being silly.
The tumours grew. They conducted a biopsy. They drilled into her head. It took eight weeks for the results to come. You can’t imagine the terror. Two months of it. Not knowing, wondering if you might die. When the results finally arrived, they said they were benign. Harmless. Fine. Silly.
They found new tumours – these ones on her spine. She was alone when they called her. She telephoned her parents, but nobody was home. Her boyfriend wasn’t picking up either. None of her friends were in. Evening had fallen before she was able to speak to anyone. All of those hours, alone with the news.
Chemotherapy made her sick. Over the course of a single weekend, all of her hair fell out. The tumours grew in size and threat. They gave her steroids. She gained four stones in one month. She had an extended stomach, a great big puffed-out moon face. She had to lift her eyelids with her finger if she wanted to see anything. Her bowels didn’t move for weeks. She had a wheelchair, a stick. Her sight became so bad that she couldn’t watch television or read. She had nothing to do but to lie there, terrified in her nauseous gloaming. She thought, I’m only twenty-six. I’m the youngest of seven children. The youngest! It’s not my turn. Early in the winter of 1995, the oncologist visited her hospital bed. He said something strange. ‘Okay, Gemma, these are your options. You can stay here, you can go to a hospice or you can go home.’
Gemma was groggy, confused. She reasoned, ‘Well, sick people go to hospital. Dying people go to a hospice. And home – that’s for fit people.’
She was delighted.
‘Home, please!’
‘Fine,’ said the doctor, kindly. ‘You’ve got those little pills and you’ve got him up there. Make sure you have a happy Christmas.’
What an odd thing to say. Have a happy Christmas? It was only October. It was some time before Gemma realised that this was her doctor’s way of telling her that they had been wrong all along. That her tumours were, in fact, malignant. That she had cancer and would be dead within four months.
She felt betrayed. She had done everything they had asked of her. Medicine was like a, b, c, wasn’t it? You got sick, they treated you and then you got better. It wasn’t supposed to be like this.
Despite her bleak prognosis and her new medication, which now only treated her symptoms, Gemma carried on taking the ‘little pills’ that her oncologist had mentioned with his gently knowing smile. To her amazement, they seemed to work. By Christmas, her eyelids had opened up. Her bowels began to move. Her sight returned. And the more of the little pills that she took, the better she became. A year later, Gemma called her oncologist’s office and asked why they hadn’t been in touch. She was angry. She knew why – it was because they had assumed that she was dead. And who were they anyway? They’re not God. They don’t decide when I’m going to die. When her oncologist next examined her, he wrote in his notes, ‘Gemma has made a remarkable recovery. Her case will remain a mystery.’
‘But it’s not a mystery to you, is it?’ I say to Gemma, who has been telling me her story in the front room of her modest Sutton Coldfield home.
‘Not to me,’ she smiles.
The ‘little pills’ Gemma Hoefkens had been taking were homeopathic. She believes that they not only saved her life, they also changed its direction forever. She is now a licensed homeopath who claims to have not seen a doctor for fourteen years.
The industry that Gemma works in is worth four million pounds a year in the UK and billions in Europe and the US. Over fifteen thousand NHS prescriptions are issued for it annually, it sells in high-street chemists and user-satisfaction ratings in Britain score above 70 per cent. And yet Gemma’s oncologist was not alone in his reservations over their efficacy. Throughout its defiant 230-year history, homeopathy has attracted the disbelieving fury of doubters from Richard Dawkins today all the way back to Charles Darwin, who wrote, ‘In homeopathy common sense and common observation come into play and both these must go to the dogs.’ Over the last few years, a campaign to stop the homeopaths has gathered into a truly damaging force. Questions have been asked in Parliament. In February 2010, the House of Commons Science and Technology Committee recommended the NHS cease funding the discipline. Even ex-Prime Minister Tony Blair has become involved, saying ‘My advice to the scientific community would be, I wouldn’t bother fighting a great battle over homeopathy.’ But they do and, at least in Britain, they are winning: between 2000 and 2011 there was an eightfold drop in NHS prescriptions. It now comprises just 0.001 per cent of the NHS’s annual drug budget. And Gemma has suffered personally at the feet of reason’s furious armies.
In February 2010, she appeared on BBC Radio Five Live, to share the details of her recovery with the public. Afterwards, someone posted the interview on YouTube. On the video, every time Gemma speaks, a yellow rubber duck appears over her face with the word ‘QUACK!’ flashing out of its mouth. The video ends with a still photograph of Gemma herself. It is framed, in shocking pink letters, with the statement: ‘DO NOT BE FOOLED. HOMEOPATHY IS A CROCK OF SHIT’. There is a blue speech bubble jutting from her mouth. It contains an additional single word rendered in bold yellow capitals. It says, ‘QUACK!!’
I unfold a printout of the yellow plastic duck and place it on the table in front of Gemma.
‘Have you seen this?’ I ask.
Her eyes flicker briefly towards it. She folds her arms.
‘Yes.’
‘How does it make you feel?’
She allows herself a moment to think.
‘It makes me feel – how professional are they? They’ve got “quack” there and a yellow plastic duck. And how un-professional is that? Who are these people who are so unprofessional? You know, who are they?’
I decided to find out.
*
In the upstairs bar of a dismal city-centre Manchester hotel, a pale platoon of anti-homeopaths is getting pleasantly drunk. These are members of the ‘Skeptic’ community, a large and swelling movement of activists and thinkers who campaign against people such as Gemma, and on behalf of science and reason. They meet in groups known as ‘Skeptics in the Pub’ and gather online to present podcasts, argue in chatrooms and compose outraged and unusually well-footnoted blogs.
They dress in comfortable jeans paired with strange polemical T-shirts (‘Stand back, I’m going to try science’, ‘I reject your reality and substitute my own’, ‘Over 1000 scientists named Steve agree’) or in dark-coloured knitwear, sleeves pushed up to elbows to regulate temperature. Huddling around low tables with pints of lager, they peck at Twitter with self-conscious frowns of concentration. The elder Skeptics – one or two of whom I recognise as speakers at this event – stand in fidgety groups by the bar, rolling back on their heels with fingers crooked over chins, listening earnestly to their neighbours. Everywhere I look, there are beards and little ponytails and cables dangling out of rucksacks. At least three of them look exactly like Dave Gorman.
This weekend, the Skeptics have gathered for the ‘QED Conference’ that has been organised jointly by the Merseyside and the Greater Manchester cells of Skeptics in the Pub. It will culminate in a mass international homeopathic overdose – a stunt that will seek to demonstrate that, as the campaign’s marketing slogan has it, ‘There’s nothing in it’.
I am curious about the Skeptics because, from an outsider’s point of view, their main hobby seems to be not believing in things. Psychics, homeopathy, chiropractors, ghosts, God – they don’t believe a word of it and that is one of their favourite things to do. The fallibility of human belief is the base upon which the Skeptics build their activism. As bracingly incredible as it was to me, it is highly likely that the ordinary Skeptic would have discovered nothing new in the chapter that precedes this one. Confirmation bias, cognitive dissonance, unconscious ego-bolstering and the many illusions of vision are their foundational texts, their Matthew, Mark, Luke and John.
Skeptics rely on the findings of science, rather than the dubious anecdotes of individuals, to inform them about the world. They are knights of hard intellect whose ultimate goal is a world free of superstitious thinking. Do not make the mistake of doubting how seriously some take this task. Later in this event, an editor of the US’s Skeptic magazine will note their responsibility as ‘safe-guarders of the truth.’ Another speaker will darkly threaten that, without their ever-watchful work, ‘Nonsense will be allowed to reign.’
Much to the irritation of the Skeptics, homeopathy has been ‘reigning’, now for more than two centuries. Its development, which began in 1790, is credited to German physician Samuel Hahnemann – who, just like Gemma, had grown disillusioned with conventional medicine. The theory says that illnesses can be cured by taking minute portions of substances which cause similar symptoms to those which ail you. So, if the bark of a toxic Peruvian tree causes symptoms similar to malaria, say, then a tiny dose of that can cure malaria. In Gemma’s case, her many dramatic maladies were, she believes, cured by causticum. When I enquired as to what causticum was, she replied somewhat reluctantly, ‘Er, you put it down drains.’
But Gemma was never in danger of being poisoned. The amount of causticum in one of her pills is really quite unbelievably small. In fact, if you buy a standard ‘30C’ dose of any homeopathic treatment, it means the active ingredient has been diluted thirty times, by a factor of 100. That might not sound like too much, until you realise that your chance of getting even one molecule of the original substance in your pill is one in a billion billion billion billion. In his influential book Bad Science, Skeptic superstar Dr Ben Goldacre explained that you would have to drink a sphere of water that stretches from the earth to the sun just to get just one solitary, pointless molecule of it.
This is why their campaign’s slogan insists that ‘There’s nothing in it’. Because there really is nothing in it. Homeopaths deny this, however, saying that when they dilute the substance, they first shake it (or ‘succuss’ it) which ‘potentises’ the water, causing it to somehow remember the active substance. The Skeptics reply that this is ‘woo-woo’, which is the word they use for nonsense.
I am quite comfortable in predicting that there is not a brain in this bar that would have been surprised to discover what happened when I broached the problem of empirical proof with Gemma. I began by asking about her practice as a homeopath, and whether the process of assessing which remedy to recommend to a patient was instinctive, or an exact science. She replied, ‘It’s an exact science. But it’s something that the scientists don’t understand yet.’
‘I read that a sphere of water a hundred and fifty million kilometres in diameter would only contain one molecule of active ingredient,’ I said.
‘I’m not the best person to talk to about that.’
‘What would your response be to a Skeptic who says it’s diluted to such an extent that there’s actually nothing in it?’
‘I’d say go and look it up.’
‘Yeah.’
‘Have you ever read any scientific studies that have looked at the efficacy of homeopathy?’
‘Yes.’
‘Which ones?’
‘Don’t ask me that question.’
As I said, nobody in this bar would be surprised to hear any of that – and that is the central and unavoidable truth about the Skeptics. They are never wrong. Indeed, that is the whole point of them. And, as one of them volunteers, being right all the time comes with its own peculiar risks. When software engineer Bryan tells me that scepticism is the philosophy by which he lives life, he feels it necessary to make an unprompted addendum: ‘It’s not about calling people stupid.’
‘Is that a common accusation?’ I ask.
‘You can come across as arrogant,’ he says. ‘Especially when you’re in this type of environment, where people tend to be into the scientific literature.’
My next conversation is with a couple of not-that-friendly-looking-to-be-honest Skeptics named Bendt and Simon. Bendt, a bearded Swede in a leather trench coat, tells me that he came to the movement via loneliness and atheism. ‘I was doing my PhD in Vancouver and looking for a social circle so I looked for atheists. From there, I went to scepticism.’
‘And what was your PhD in?’ I ask.
‘Nuclear physics.’
Rob, meanwhile, was a schoolboy magician who became entranced by an individual who, like him, also began his journey into scepticism by performing simple magic tricks and marvelling at the ease by which you can fool a human. The man who inspired him, however, was to become a hero to rationalist campaigners all over the world. Now in his eighties, he has spent a long and celebrated life committing spectacular debunkings of psychics, spoonbenders and peddlers in ‘woo woo’ – a phrase that he invented. He is James Randi, king of the Skeptics, a near-legend in these circles. One of the many actions that Randi is celebrated for is his long-standing offer, made through his James Randi Educational Foundation (JREF), of one million dollars to any individual that can prove any aspect of the supernatural. That includes homeopathy. Indeed, one of his latest triumphs involves a high-profile Greek homeopath named George Vithoulkas, whose own ‘Million Dollar Challenge’ broke down just as his test was approaching. It is said that Vithoulkas dodged his judgement day by suddenly refusing to fill out the standard JREF application form, thereby triggering the collapse of the process. In a typically merciless statement that was published on Randi’s personal blog (in which he also found room to call Vithoulkas a ‘strange man,’ ‘self-deluded’ and a ‘naif’) he said, ‘Many would-be applicants have considered themselves above such a simple requirement, but no exception has ever been made, nor will it be made.’
I meet another software engineer, named Colin, who credits Randi’s debunking of Uri Geller – famous for his psychic spoon-bending – for his interest in critical thinking. ‘He’s a really big hero,’ says Colin, who calls homeopathy a ‘medical scam’ and describes it as his principal interest. When I ask which homeopathy studies he has read, he dodges the question. ‘I’m not a scientist so I can’t really comment on the studies. But I’m fascinated by the absurdity of the whole thing.’
Conventioneer Dominic, meanwhile, is equally scathing. ‘Homeopathy really is silly,’ he chuckles. ‘I look forward to taking part in the overdose.’
What is it, I wonder, that he wants to achieve with his campaigning?
‘Just getting an awareness out there of how silly homeopathy is,’ he says.
‘Have you read any scientific studies into homeopathy?’
‘Not personally.’
‘I’m not sure I understand the point of it all,’ I say. ‘Isn’t it just harassing a load of old ladies?’
‘It isn’t just a load of old ladies,’ he says. ‘Lots of people, if they take homeopathy and think it’s real medicine, they might avoid going to an actual doctor.’
He makes a good point.
‘Do you know anyone that that’s happened to?’
‘Not personally.’ A moment passes, as he ponders the sceptical ramifications of this admission. ‘Being sceptical, unless I know someone who has done this, I can’t say for sure it has happened. But I have heard stories.’
‘If you don’t know anyone personally who has come to harm, then what makes you so angry about it?’
‘Simply from a consumer-protection point of view.’
‘You’re interested in consumer-protection issues?’
‘Yes.’
‘And what other consumer-protection issues are you involved with?’
‘I buy Which? magazine,’ he says. ‘And things like that.’
Finally, I settle down with Mark, who explains his interest in scepticism thus: ‘It’s incredibly important that people maintain a rational mindset, a sceptical mindset, with everything they approach in life and that they never get carried away with wishful thinking, with stuff they would like to be true.’
I sigh, my gaze emptying and slipping in the direction of the ugly carpet. I feel unaccountably depressed.
We talk on, and Mark says that his principal sceptical interest is in evolution, so I tell him about my time in Gympie with John Mackay, and about his opposite, the scientist Nathan Lo, who told me that much of the peril lay in the fact that the creationist story is simple to understand, whereas the science can be hard. But Mark, a twenty-five-year-old cinema employee, does not agree with what the doctor of molecular evolution had to say.
‘I don’t think it’s difficult,’ he says. ‘In fact, the beauty of evolution is that it’s incredibly easy to understand.’
I present the argument that, in essence, it is all faith – most of us do not look at the raw evidence for ourselves, but rely on charismatic leaders who reinforce our prejudices to do it for us. Mark nods approvingly.
‘If you truly want the truth, you have to do it yourself,’ he says.
‘But who’s got time?’ I say.
‘It’s not about who’s got time,’ he says. ‘It’s about not trying to make reality fit what you want it to fit. We need to tell people to come to their own conclusions rather than what someone else tells them.’
‘So, what evidence have you personally studied regarding evolution?’ I ask.
‘Well, there’s such a mound of evidence with something like evolution,’ he sighs. ‘There are fossils in the ground that show a step by step picture of how we got to be how we are.’
‘Fossils?’ I ask.
‘Fossils,’ he nods.
‘So you’ve studied fossils?’
‘No, not personally,’ he says. ‘But, um, the fact that I’ve not studied fossils personally – the vast majority of people haven’t studied fossils personally. Has anyone studied God personally?’
I don’t understand exactly what Mark means, but as the glumness that has come over me is apparently not lifting, I decide that it is time for bed.
*
I don’t know if there is any way back from the revelation that you are wrong and there is nothing you can do about it. But that, it seems to me, is the principal lesson of experimental psychology. We are blind to the effects of our own cognitive traps. You could even argue that it is these very traps – their unique patterns – that make us who we are. These days, when pondering matters of personal belief, the most appropriate question we can ask of ourselves is no longer ‘Am I right?’ but ‘How mistaken am I, how biased?’
We have designed a system of knowledge to combat all this. Science is the opposite of religion. Its laws are not sensed in visions or divined by charismatics claiming access to a supernatural being. They are the result of sweat and fight and genius. Everything it knows, it has earned. The scientific process is what happens when you gather enough Homo sapiens brains together and give them time to think. It is astonishing: the greatest achievement of our species. The people gathered for this conference know this. They want to promote it; to celebrate it. As I keep having to remind myself mournfully, the Skeptics are right.
Why ‘mournfully’? Why this gloomy sense? Why the defensive feeling when I walked into the bar downstairs? Why are my instincts, in all their kneejerk ignorance, telling me that I should be on the attack, that these men and women are not of my tribe?
These are questions that journalists are not well practised in asking. We are similar to the Skeptics, in that we like to imagine ourselves as professional seekers of truth. We are led by facts, not prejudice or childish interpersonal likes and dislikes. I lie back on my hotel bed, recalling my behaviour earlier on – wandering about the place, speaking to Skeptics one by one and asking impertinently, ‘What studies into homeopathy have you read? What studies into homeopathy have you read?’
Urgh.
When I was familiarising myself with the sceptical literature, I came across a book that contained an enlightening passage on John Mack, the Harvard heretic who had to go to war with his dean in order to defend his right to study alien abduction. Written by Dr Michael Shermer – founding publisher of the magazine Skeptic and director of the Skeptics Society – Why People Believe Weird Things closes with a devastating analysis of his beliefs.
Mack’s cognitive journey reads like a perfect study in how the brain likes to rearrange the evidence of the outside world in order to match its inner models. (Not that Shermer doubts that Mack’s patients were sincere: ‘Knowing what we do about the fantastic imagery that the brain is capable of producing,’ he writes, ‘experiencer’s experiences are nothing more than mental representations of strictly internal brain phenomena.’) Mack had some tricky cognitive dissonance to deal with: the lack of physical evidence that they had actually been taken aboard an alien craft. He acknowledged this was a problem, admitting, ‘there is no firm proof that abduction was the cause of their absence,’ but then soothed the dissonance away by dismissing the entire notion of physical evidence. In an interview with Time magazine he complained, ‘I don’t know why there’s such a zeal to find a conventional physical explanation. We’ve lost all that ability to know a world beyond the physical. I am a bridge between the two worlds.’
Here was a man as intelligent as you could hope for, who found re-imagining the nature of reality itself easier than admitting the obvious possibility that his patients were simply delusional. In his book, Shermer did a superb job on Mack. He was knowledgeable, sceptical, credible and wise. He was fantastic.
I found the whole thing really annoying.
Over the last few months, Mack has become a kind of hero to me. Despite his earlier caution, he ended up believing in amazing things: intergalactic space travel and terrifying encounters in alien craft that travelled seamlessly through non-physical dimensions. And when his bosses tried to silence him, he hired a lawyer. He fought back against the dean and his dreary minions. He battled hard in the name of craziness. He was a heretic, an enemy of reason. He told a journalist from Time magazine, ‘I am a bridge between the two worlds.’ And I loved him.
But there it was – the miserable truth. I heard it downstairs, less than an hour ago: ‘It’s incredibly important that people never get carried away with wishful thinking, with stuff they would like to be true.’
Mark the Skeptic was right, of course. And now that I have learned to mistrust myself, to realise that ‘instinct’ is merely ego-bolstering bias prancing about in the robes of wisdom, I am compelled to question why I would like so much for Mark to be wrong. I wonder if it relates to the truth hinted at by the university students who were asked to read the essay about Rasputin. The readers preferred him when his birthday matched their own. Without even being conscious of what was happening, something in their brains recognised a similarity and hugged the diabolical monk just a little bit closer. It seems to me that we spend our lives hunting for ourselves: we are moved by a novel when we recognise our experiences in those of the hero, just as we delight in the constellation of similarities that we discover in a new romantic partner. Perhaps we never really fall in love with someone else after all, and when we gaze into the eyes of our other half we are actually admiring our own reflection.
If all this is true, and my biases throb warmly when I detect pieces of myself, then why, on meeting the Skeptics, did I feel drawn to the defence of the homeopaths? What is the Rasputin trace that I sense in them, and in John Mack? I wonder if it has to do with the various madnesses that I once suffered. The delusional jealousy, the vandalism, the pathological drinking and theft. I wonder if it has to do with the fact that I was unhappy at school, that I made war with my teachers and that I had little in common with the kind of students who were good at science and mathematics. Am I, by instinct, with the irrationals? Are they my tribe? If so, that makes me an unreliable narrator. Which is not a good look for a journalist.
*
I am up on the balcony watching the three hundred assembled conventioneers enjoying a presentation about ghosts. A good proportion of them have come dressed in the white T-shirts that are being sold to promote tomorrow’s homeopathic overdose. An even larger number have screens of various sizes in their laps and are managing to be sceptical about ghosts while interacting fitfully with their illuminated computer-extensions.
I recognise one of the panellists. Professor Chris French, a former editor of the UK’s The Skeptic magazine and a professor of psychology who heads the Anomalistic Psychology Research Unit at the University of London. I once interviewed him, for the Financial Times.
The conventioneers laugh, as one, at a joke that French has made. I coldly survey the endless rows of chuckling white-shirted forms beneath me. There they are, I think. All the Skeptics, all gathered together, all thinking for themselves.
I have got to stop this.
I sit alone and try to rearrange my thoughts into something that resembles impartiality, but my biases are flexing madly. I am surprised, for a start, that so few of these disciples of empirical evidence seem to be familiar with the scientific literature on the subject that impassions them so. I am suspicious, too, about the real source of their rage. If they are motivated, as they frequently insist, by altruistic concern over the dangers of supernatural belief, why do they not obsess over jihadist Muslims, homophobic Christians or racist Jewish settlers? Why this focus on stage psychics, ghost-hunters and alt-med hippies? And isn’t the scene before me precisely the kind of thing that the Stanford Professor Philip Zimbardo warns against? The first two steps in his recipe for evil – assign yourself a role, and become a member of a group. ‘Groups can have powerful influences on individual behaviour,’ he said. Weren’t his doomed prison guards just like this: bonded by their fight, and their perceived superiority, in opposition to a common enemy?
One of the convention’s organisers, Michael ‘Marsh’ Marshall, arrives. Charismatic, confident and eloquent, the twenty-seven-year-old marketing executive in the crisply ironed shirt seems at ease both on stage addressing the conventioneers and on television news shows, on which he has recently been in demand on account of his campaign against the homeopaths.
Marsh’s journey into the movement began when he was a sixth-form student. ‘I used to do palm-readings,’ he tells me. ‘I was pretty good at it, but I didn’t believe it for a second. I just accidentally picked up some cold-reading techniques. It made me realise how easy it is to convince people of things that aren’t true – and to convince yourself. I’ve been interested in psychics ever since, because there’s a real harm in it. I had a reasonably well-documented tussle with a Liverpool psychic called Joe Power,’ he says, recalling it with a smile. ‘I went along to see him at one of his book signings and he didn’t take too kindly to me questioning him and saying, “Well, if you can really do what you’re saying then that’s fantastic. Just test it first. If it turns out you pass the test, we’re totally on board with you.”’ He shakes his head in amused disbelief. ‘He just went mental at me. He called me every name under the sun.’
Unlike the Skeptics I met last night, Marsh is familiar with a case in which homeopathy has been harmful – and appallingly so. He recounts the case of an Australian baby who was diagnosed with eczema aged four months and ended up dying five months later after her father, a homeopathy lecturer, insisted on treating her with his highly diluted potions. When her parents were imprisoned in 2009, the judge blamed the girl’s death on her father’s ‘arrogant approach’ to homeopathy.
‘I find cases like that really distressing,’ Marsh says. ‘Homeopathy is magic. That’s what we’re trying to get across with the overdose. We know we’re not going to convince the hardened believers. It’s the people who wander into Boots with a headache and say, “Homeopathy – I’ll try that” that we want to reach. To those people, we want to say, “There is no evidence for homeopathy. The science has been done. It simply doesn’t work.”’
I can’t help myself.
‘Have you read any of the studies?’ I ask.
‘Yes,’ he says.
I sit up.
‘And understood them?’
‘Yes.’
‘Which ones?’
A touch of irritation becomes evident around the edges of his eyes.
‘I can’t quote their names.’
I ask Marsh if there is a risk that, with activists gathering regularly to agree with each other that the ‘fringe sciences’ are scams and their practitioners fraudulent or deluded, that something important might get missed.
There is a famous quote by William James, who spoke of the scientific gains that can be made by paying attention to the ‘dust-cloud of exceptional observations’ that floats around ‘the accredited and orderly facts of every science.’ What if some young academic who is interested in an esoteric subject such as homeopathy or ESP is intimidated by the roar of the crowd into ignoring his vocation? Maybe, in among all this junk science, some crucial anomaly exists, the study of which could lead to a fantastic breakthrough? But now it won’t happen, because reason’s fightback is too fierce, too gloating, too much of a threat to a young scientist’s reputation. To be a Skeptic seems to involve signing up to a predetermined rainbow of unbeliefs. What if it slips into dogma?
‘By definition to be involved in scepticism, you’re someone who is critical of the world, is evaluating the world, and that in itself is a good inoculation against dogma,’ he says. ‘And anyway, decisions on that kind of stuff are not made on consensus or popularity, they’re made on evidence.’
It is, in other words, a restatement of his message to the psychic Joe Power. As soon as anyone proves homeopathy, mediumship or extrasensory perception, they will humbly admit that they have been wrong all along. The American rationalist-celebrity Rebecca Watson (another ex-magician who was inspired by James Randi) gives a typical definition of the Skeptic as one who is ‘willing to examine their beliefs and [is] always open to new evidence, [and has] the ability to hold a belief and, if new evidence comes in, to completely change your mind.’ This is why James Randi frequently rejects the title ‘debunker’, preferring ‘investigator’, and it is why, in the UK, there is a general preference for the American spelling, ‘Skeptic’: ‘“Sceptic” tends to get confused with cynic – de facto negativity,’ explains Marsh. ‘We like to emphasise that if stuff proves to be true, we’ll believe it.’
Later that day, one of the world’s most highly regarded sceptical activists will also claim a special immunity to dogmatic thinking on behalf of the warriors of science. Dr Steven Novella is a clinical neurologist from Yale University who presents the hit weekly podcast The Skeptics’ Guide to the Universe. ‘This is an intellectual community,’ Novella tells me. ‘The reason why scepticism is incompatible with dogma and ideology is; it’s very anti-dogmatic and anti-ideological at its core.’
I am startled to learn that Novella is so sceptical of homeopathy that he does not even accept its worth as an unusually sophisticated exercise in placebo theatre. He denies that placebo has any true physiological effect, insisting that it is purely psychological and that studies suggesting otherwise often fall victim to what is known as ‘The Hawthorne Effect’. ‘The act of participating in a clinical trial, of being observed, can make people feel better,’ he explains. ‘We have the data on this. People think they’re feeling better, but they’re not.’
The homeopaths themselves, says Novella, are a mix of the deluded and the knowingly fraudulent. ‘There’s always going to be a certain percentage of psychopathic con artists,’ he says. ‘In any system where people believe in magic, con artists smell that. It’s like blood in the water to them. That aside, there’s the people who are just profoundly naive. Then there are the promoters, like Dana Ullman [one of America’s most active defenders of homeopathy]. They’re really despicable because they get called out on the inaccuracy of the information they’re providing. Then the next time they come around, they’re peddling the same crap again.’
Before the day’s proceedings close, I see Professor Chris French alone behind a trestle table that is piled with issues of The Skeptic magazine. I wander up to him to say hello.
‘Oh, hi,’ he says pleasantly. ‘I really enjoyed your ghost book.’
‘Thanks!’ I say, beaming.
‘But I have to say, you’re not what I’d call a Skeptic.’
I sigh and wander off to spend the remainder of the day moseying in and out of talks. The final event of the evening is set by a sceptical musician from the US named George Hrab. As I leave the convention hall for bed, he is leading the crowd in a sing-along, the chorus of which goes: ‘You won’t believe what a Skeptic I am/I can’t believe you believe in that sham/We disagree but I still give a damn.’
And in the morning, I overdose.
*
‘Has everyone got the vial of pills we prepared for you?’ says Marsh, up on the stage. On each seat there is a small plastic container with a white screw-cap, each one holding a palmful of pills. ‘If you haven’t got any, there are helpers at the back of the room who have spare pills so, don’t worry, you will be able to overdose with us. In the time we’ve got before we’re going to attempt to kill ourselves I’m going to take you through what’s been happening over the last forty-eight hours.’
Marsh counts seventy cities in thirty countries across the world that are taking part in today’s overdose. Then he proudly introduces a special video recording that has been made for today. He turns towards the huge screen, grinning, and suddenly – there he is. Gazing down at the crowd with his bright grey eyes, pink ears, bald head and famous white wizard’s beard, it is the man Professor Chris French calls ‘the patron saint of the Skeptics.’
‘Hello,’ he says. ‘I’m James Randi.’
We watch in reverent silence as Randi talks of the times that he has overdosed in order to show that these ‘scam medications’ have no effect. ‘Every day, parents of sick children are coming home from their pharmacy with fake medicine, leaving their children in distress because these manufacturers and these stores don’t want consumers to know the truth,’ he says. ‘Every reputable study of these fake drugs has shown them to have no more effect than sugar pills.’
And then the moment arrives. The crowd shouts, ‘3, 2, 1, There’s nothing in it!’ And the sound of three hundred nerds crunching nothing fills the conference hall. Marsh happily surveys the room.
‘Is anyone dead yet?’
*
Skeptic after Skeptic at the Manchester conference told me the same thing. Despite mostly admitting they were unfamiliar with the scientific literature, they all confidently insisted, ‘There is no evidence for homeopathy.’ James Randi himself has said that ‘any definitive tests that have been done have been negative’. But this, I am subsequently informed, is not true. The website of the British Homeopathic Association notes 142 studies that have been published in ‘good quality’ journals of which just eight, it says, were negative. Meanwhile, Dr Alexander Tournier of the Homeopathy Research Institute – who became an adherent when he was studying quantum physics at Cambridge University – tells me, ‘If you talk to Skeptics they will acknowledge a paper that was published in the Lancet in 2005, which is known as “Shang et al.”. That included a hundred and ten respectable studies of homeopathy, many of which were positive. You can’t say that’s nothing.’
I discover all this with a sense of woozy betrayal. I had put my suspicion of the Skeptics down to my own unfair prejudices. I believed every word that they told me. My irritation has a strange effect, coating the little facts with layers of emotion, exaggerating the mild intellectual sleight-of-hand until it seems personal – a conspiracy of enemies misleading me, mocking me. I am reminded of the bickering UFO-spotters who hardened their positions the moment that they were challenged. I think, too, of John Mackay’s discovery of atheist propaganda in his textbook, and how this perceived mistreatment by ideologues threw him into the arms of the enemy. I know how he felt.
I decide to confess all to Andy Lewis, the author of the sceptical blog The Quackometer, who has agreed to guide me through some of the complex science that is involved in homeopathy. To my relief, he seems to understand. ‘Yes, many Skeptics can be pretty lazy and say, “There is no evidence,”’ he writes in an email. ‘A slightly better approach would be to say, “There is no good evidence.” I can understand how you might have felt slightly misled.’
One of the most remarkable attempts at finding laboratory proof that homeopathy works began with the dramatic events of June 1988. That was when the world’s most respected scientific journal, Nature, published a study that apparently demonstrated that water did, indeed, have a memory. The research team was led by a widely respected scientist, Dr Jacques Benveniste – a senior director of the French medical research organisation INSERM 200.
Benveniste was initially sceptical of homeopathy. ‘The first time I heard the word, I thought it was a sexual disease,’ he said, in a 1994 interview for BBC TV. He had been working on allergies for fourteen years, when one of his forty-strong team claimed to have seen that some cells in a blood sample had an allergic response to an allergen that had been heavily diluted.
‘I had the feeling of setting my foot in a completely unknown world,’ said Benveniste. ‘Something that was so strange that I couldn’t even envision what was going on.’
Fascinated, he instructed his best researcher, Dr Elisabeth Davenas, to investigate. The culmination of this work was his Nature paper which caused an international sensation, despite its being published with two unusual conditions: first, that Benveniste obtain prior confirmation of his results from other laboratories; second, that a team selected by Nature be allowed to investigate his laboratory following publication. Benveniste accepted these conditions; the results were reportedly replicated by four laboratories, in Milan, Italy; in Toronto, Canada; in Tel-Aviv, Israel; and in Marseille, France.
But the ‘editorial reservations’ scandalised Benveniste. He was enraged, arguing that in his view the team that was appointed to investigate him was not appropriately recruited. It was made up of the Nature editor who had written the editorial, a fraud investigator and, of course, James Randi.
A replication was attempted. With everyone present, Dr Elisabeth Davenas – a homeopathy proponent who had interpreted all the original data – counted the number of cells that had been ‘degranulated’ by whatever agent it had been exposed to. At first, things looked good for Benveniste. When Davenas counted the blood that had been dosed with a homeopathic dilution and compared it with blood that had been treated with distilled water, the result was significant. But the investigators made Davenas assess the samples a second time – and this time, they weren’t labelled. When Davenas counted now, without knowing which was the homeopathic-treated blood and which was not, the test failed. It was almost as if she was operating under some powerful unconscious bias that was affecting her judgement. When the result was revealed, some of Benveniste’s scientists wept.
‘His whole team was playing a trick on itself,’ Nature’s editor, John Maddox, told the BBC. ‘They very rarely made these measurements blind, which meant that anyone who knew what he was looking for could bias his own counting to get the kind of answer he expected.’
Their report was published in Nature in July 1988, under the headline, ‘“High-dilution” experiments a delusion’. It was devastating. They complained at the fact that Benveniste’s lab was partially funded by a major homeopathy company and noted several potential flaws in his processes, while dismissing the claims of replication and describing homeopathy as a ‘folklore’ that ‘pervades’ Benveniste’s laboratory.
Benveniste fought back, deriding the Nature team’s ‘mockery of scientific inquiry’. He was outraged that they had allowed one negative result to ‘blot out five years of our work.’ He described the investigation as a ‘pantomime’ during which ‘a tornado of intense and constant suspicion, fear and psychological and intellectual pressure unfit for scientific work swept our lab.’ The team, he said, ‘imposed a deadly silence in the counting room, yet loud laughter was heard where he was filling chambers. There, during this critical process, was Randi playing tricks, distracting the technician in charge of its supervision.’ Benveniste finished his grand defence, also published in Nature, by saying, ‘Science flourishes only in freedom. We must not let, at any price, fear, blackmail, anonymous accusation, libel and deceit nest in our labs. Our colleagues are overwhelmingly utmost decent people, not criminals. To them, I say: never, but never, let anything like this happen – never let these people get in your lab.’
Two years later, he was fired.
The adventure of Dr Jacques Benveniste tells of a crucial principle of sceptical thought: that extraordinary claims require extraordinary evidence. If we are going to allow homeopathy, and therefore overturn much that is widely accepted in science, then we must reasonably expect the conclusions of its study to be exceptional. The tests must be painstakingly designed, and their results consistent, replicable and significant.
So what of the hundred and ten studies that Dr Alexander Tournier presented in his defence? Some of these may well conclude that homeopathy works, but are they any good? This is exactly what ‘Shang et al.’, the famous paper that Tournier referenced, sought to discover.
When different scientists tackle the same problem and produce conflicting results, one way of making sense of them all is to conduct a meta-analysis. You take the trials, use complex mathematical formulae to blend their data and end up with what you hope is an ultimate conclusion. That is what Professor Aijing Shang’s team, at the University of Berne in Switzerland, sought to do for homeopathy. It was an ambitious project and inevitably controversial. After more than two hundred years of ferocious argument, we would finally know: Does homeopathy work?
To discuss ‘Shang et al.’, I call Dana Ullman, the US homeopath picked out as especially ‘despicable’ by Dr Steven Novella. I begin by asking for his thoughts on the Skeptics.
‘They’re a mixed and motley crew,’ he says. ‘They’re medical fundamentalists and because they follow James Randi, who is a magician, they seek to purposefully misdirect the real issues in healthcare. Some are Big Pharma shills, others are just misinformed. A lot of them are science nerds. I have a science nerd in me, but the difference between me and the average science nerd is that many of them were abused as youngsters. They were hyper-rational and they had inadequate social skills and now they’re on the Internet getting their venom out. They’re bullying back. So my analysis of the reason why some of them are irrationally venomous – and you can use that term: I determine that many of them are irrationally venomous – is because they had a difficult childhood where they were abused and now they’re getting back.’
We move on to Shang. His team began by looking for studies of homeopathy that were sophisticated enough to take into account the effects of placebo. Just as Dr Tournier told me, they ended up with a hundred and ten studies that looked at homeopathy’s effect on a wide array of medical conditions.
They wanted to compare these with studies of conventional medicine. So, for each one of their homeopathic studies, they found a matching study from the world of mainstream medication that looked at treatment of the same disorder. So for every test of homeopathy on asthma, for example, they found a test of ordinary medicine on asthma.
First, they analysed the two sets of papers separately. They found that both conventional medicine and homeopathy showed a positive effect above placebo. Simply put, they both worked.
Next, they had a look at the quality of each one of those studies. Taking into account variables such as the number of people who took part in each test, they ordered them from the best to the worst and found that the better the study was, the worse the result for homeopathy.
Finally, they isolated the finest homeopathy studies in their pool of a hundred and ten. They found eight that were of the very highest quality. All of them concluded that the evidence for it was ‘weak’ and ‘compatible with the notion that the clinical effects of homoeopathy are placebo effects.’
The result was damning. Homeopathy is nothing more than placebo. The Lancet published the study alongside an editorial headlined ‘The End of Homeopathy’.
‘Ha ha ha!’ says Dana.
‘You’re laughing,’ I note.
‘Yes, I laugh at people who are sceptical of homeopathy and use Shang as their firmest body of evidence. People who do that have their feet planted firmly in mid-air. The ground that they’re standing on is Jell-O.’
Dana has several criticisms of Shang. He says that a series of studies that showed strong effects for homeopathy were unfairly ignored. He says that a subsequent critique of the study, published in the Journal of Clinical Epidemiology, accused Shang of ‘post-hoc analysis’ – that is, gathering his evidence first and then using it to find a way to prove homeopathy wrong. He says that some of the papers included were not intended to show whether homeopathy worked. Rather, they were exploratory ‘pilot studies’, carried out to test the design of a proposed experiment for potential problems before it is embarked upon properly. And yet negative results for pilot studies were taken by Shang to be conclusive, and therefore damning of homeopathy in general.
Finally, he disputes the entire basis of what Shang describes as a ‘high quality’ study. In science generally, it is taken to be logically sound that the more people who take part in a test, the more accurate the results will be. However, Dana says that this ignores the basic principles of homeopathy. When you visit a homeopath with stomach pains, say, that homeopath will not only take into account your chief complaint. Rather, he will talk to you for perhaps an hour about a wide range of subjects and take all sorts of apparently unrelated facts into his final decision in what potion or pill to recommend. Therefore, says Dana, the smaller studies are the most accurate, as these were more likely to be the ones in which an individual homeopath took the time to dispense an accurate remedy.
When I recount all this to Andy Lewis of The Quackometer, he chuckles knowingly. ‘These are all things Dana has said before, bar the marvellous one where he says small trials are better trials,’ he says. ‘That shows quite a lot of chutzpah. What did you think of that?’
‘To me, it makes sense,’ I admit. ‘Although I do appreciate that it leads us into dangerous territory.’
‘But he’s not telling you the whole truth.’
Andy takes me through Dana’s argument point by point. He says Shang ‘excluded all sorts of trials, and the reasons they were excluded were very specifically set out in the paper. He included a clear methodology because he wanted to make sure that he gave both sides a fair crack of the whip. If Dana could show that he had ignored their criteria, it would be a fatal blow. But no one’s done that.’
Next, Andy tells me that the accusation that Shang was engaged in post-hoc analysis was not, in fact, published in the Journal of Clinical Epidemiology, which is an ‘as good as you can get journal,’ but in a publication that deals exclusively with homeopathy. ‘Oh, what can you say about that?’ he sighs.
Of Dana’s assertion that homeopathy will only work when ‘individualised’ he says, ‘He’s not being complete with the truth.’ In fact, the father of homeopathy, Hahnemann himself, designed a scheme called Genus Epidemicus in which broad symptoms could be treated with the same medication. Indeed, that’s why anyone can walk into Boots without an appointment and buy a homeopathic remedy for a toothache. Also, Andy adds, there are lots of trials for individualised homeopathy. ‘Forty or fifty at least. And the results for these as just as poor as all the others.’
Finally, of Dana’s complaint that trials that were included were only exploratory, Andy says: ‘The vast majority of homeopathy studies would be pilot studies. I don’t think the inclusion criteria took that into account.’
‘So does Dana have a point, then?’
‘Um …’
‘Would you go that far?’
‘Dana is always wrong. So, no. I wouldn’t go that far.’
*
Before his death in 2004, Dr Jacques Benveniste had begun an ambitious project. ‘One day,’ he said, ‘we are going to be able to get our drugs on the phone. There is no reason why we can’t have this, or have a whole pharmacy on a chip on our credit card.’
His words were prophetic. Today you can send a strand of your hair to a homeopath, who will dip it into a solution and beam its health-giving vibrations back to you through the air. You can buy machines that project homeopathic properties into blank pills. It doesn’t require the actual original liquid dilutions – just get someone to email over the correct numeric code for, say, ‘milk of the dolphin’, ‘dinosaur bone’ or ‘blood of the grizzly bear’ and tap it in. Using this ‘radionic’ method, you don’t even need pills. One proponent travels through Africa, handing MP3 files to people with AIDS.
Back in Sutton Coldfield, I wanted to discover a bit more about Gemma’s practice. Despite the Skeptics’ many campaigns, there are already laws in place that seek to stop homeopaths doing harm. The Cancer Act 1939 makes it illegal to advertise the ability to cure cancer. This made me curious about Gemma. Although her website makes no mention of the condition, I wanted to know how she dealt with patients while publicly crediting homeopathy with her own recovery. I asked if she had ever treated anyone who was suffering from it.
‘Yes, I have,’ she said. ‘One with brain tumours. He was given two years to live. He came to see me, had some treatment, had a scan and they’d gone.’
‘You realise that claiming the ability to cure cancer is illegal?’
‘I don’t treat the cancer,’ she says. ‘I treat the individual.’
‘You treat the individual with cancer.’
‘I treat people with diseases, but I treat them as an individual.’
‘So if I came to you saying, “I’ve got cancer, I need medicine” you wouldn’t treat that cancer, but the cancer would still disappear?’
She shrugged, ‘Might do.’
‘How do you know that your cancer didn’t just go into remission?’
She looked baffled. Then angry.
‘I was on my deathbed! And it suddenly changed, did it?’
We sat there, for a moment, in the space that now she uses as a consulting room. I took in the books, the pamphlets, the framed certificate in ‘homeopathy and holistic healing’ from ‘The Lakeland College’ and the large chart that explained what to do in various ‘Homeopathy Emergencies’ and I asked one final question.
‘If you died and went to heaven and God sat you down and told you, “Gemma, I have to tell you – homeopathy is nonsense.” Would you believe him?’
She answered in an instant.
‘No.’