[O]ne of the greatest challenges we face is the widespread public belief in the scientific method. . . . We’re too reliant on the scientific method, and it stands in our way of forging ahead.
—naturopath Daniel Rubin1
All professions have assholes, including medicine, and their existence does not invalidate science.
—comment by “madder” on Respectful Insolence2
In 2000 it was estimated that in the UK the annual expenditure on alternative medicine was at least £1.6 billion (then about $2.25 billion). It’s believed a comparable figure for the US would be about $27 billion. According to a slightly earlier estimate, done in 1997, the UK has about fifty thousand practitioners offering alternative medicine, whether registered with a professional body or not, plus perhaps ten thousand orthodox physicians who offer some or other alternative therapy in addition to the norm. These are frightening figures when you bear in mind that there’s no reason to believe these therapies work at all beyond any placebo benefit. After all, many of the remedies now described as complementary or alternative medicine (CAM)—prayer, therapeutic touch, herbal medicine—are those that didn’t do so well against the Black Death. Techniques we today call CAM were unsuccessful for millennia against smallpox; it took modern scientific medicine mere decades to wipe smallpox out entirely.
Yet still people insist powdered pond scum is a cure for cancer and essence of goose dropping the sure way to restore flagging libido. It seems a single anecdotal report, no matter how vague, no matter how far distanced from the direct experience of the individual repeating it, outweighs any number of deeply researched double-blind trials and peer-reviewed scientific conclusions.
Does this mean people who believe the bogus claims for alternative therapies are stupid? No. Well, obviously some are; but the vast majority are victims of a media environment in which—in matters relating to other sciences as well as medicine—it’s deemed more desirable to promote baloney than to offer a reality check. Someone’s remarkable remission of seemingly terminal cancer, if attributed to an infusion of bladderwort or a mail-order TM course, can make front-page news in the tabloid press. But if someone who lives up the road from you responds well to chemotherapy, that’s not news. And even less is it news if someone who’s been trying to fight cancer with magnetotherapy or reflexology succumbs to the disease—or to the lack of effective treatment for the disease.
In other words, when we make our medical choices we’re very often not just underinformed but actively misinformed by our news media . . . and quite a number of us die every year because of it.
The people who rely on CAM may not always be the ones you expect. A 1998 study3 revealed that in 1997 as many as 42 percent of the US population used at least one alternative therapy and that more women (49 percent) than men (38 percent) made use of CAM. Mildly unexpected was that the age group most likely to turn to CAM was the 36–49 bracket. More startling was that use of CAM was highest among people with a college education, fully 51 percent of whom turned to CAM during the survey year 1997, and among people with incomes over $50,000 (48 percent). Thus, the very people best able to afford healthcare and educationally best fitted to recognize its value were the ones making most use of CAM. Possibly we’re looking at a consequence of the ’70s generation’s later-life New Agery; more likely the problem lies in the media’s adulatory coverage of quackery.
A particular hotbed of this is to be found among the far-right websites/ezines like Newsmax, WorldNetDaily, and Personal Liberty Digest, all of which bombard their hapless subscribers not just with spun news and dodgy looking investment schemes but with promotions of fringe therapies, cancer cures being a particular favorite. Here’s the selection of articles offered by Newsmax on a random date (November 24, 2010):
The answer to that last question is, obviously, YES INDEEDY . . . and Dr. Crandall is hawking a book to prove it, available at a !!SPECIAL PRICE!! to Newsmax readers.
CAM gains support from some surprising quarters. In the UK there has been much controversy over governmental funding of CAM research. Some US insurance companies will underwrite their clients’ treatment with homeo-pathic or other alternative therapies. Is this a vindication of CAM claims or, more sinisterly, a matter of fiscal calculation? Recipients of CAM die sooner—and that’s where the companies’ profits lie.
Even so, the companies’ approach can be seen as part of a growing acceptance of CAM—as assisting the fulfillment of the CAMsters’ quest for respectability. Many schools of CAM, in hopes of persuading more of the public of their responsible approach to medicine, have set up their own regulatory authorities—for example, the British chiropractic Association (see page 72), the Israeli Association of Classical Homeopathy, the American Association of Acupuncture and Oriental Medicine—to supervise the activities and claims of practitioners. Well, maybe. The trouble is that, if a therapy’s bogus, it really doesn’t much matter if it’s regulated or not: It’s still bogus. Another approach is to adapt the format of the peer-reviewed journal to promote a denialist worldview. An example is Journal of American Physicians and Surgeons (see page 117), which publishes fringe-science papers and favorably reviews denialist books, while also advancing a politically conservative agenda.
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It’s not just therapies that can be alternative; diseases and conditions can be as well.
A relative newcomer to the scene of dubious medical conditions is “chronic Lyme disease.” But what exactly is it? Lyme disease is spread by ticks carrying the Borrelia bacillus; in North America the culprit is B. burgdorferi, while in Europe B. afzelii and B. garinii are also involved. Although there are many indications of a lingering, little understood post–Lyme disease syndrome, or Stage 4 Lyme disease, there’s no known mechanism that would allow for a chronic form. There seems, in short, considerable doubt that any such ailment as chronic Lyme disease exists.
Yet some people believe themselves to be suffering from it, and some physicians either believe likewise or at least are willing to go along with their patients’ self-diagnoses. The supposed remedy involves long-term treatment with antibiotics, even though there’s no evidence Borrelia is present or active. Four controlled trials (to date) have found no indication that long-term antibiotics are of use in such cases. The Infectious Diseases Society of America, the American Academy of Neurology, and the National Institutes of Health are among the academic institutions to have decided the practice is useless and potentially harmful; they are countered by the International Lyme and Associated Diseases Society (ILADS), an apparently grassroots organization supposedly concerned with patients’ well-being. In “Inaccurate Information about Lyme Disease on the Internet”4 James D. Cooper and Henry M. Feder Jr. reported that the ILADS site was inaccurate about the diagnosis, serology, and treatment of Lyme disease, plus much more; of the eight categories of information Cooper and Feder tested, the ILADS site discussed five, and in all five instances its information was inaccurate.
If the antibiotics simply had a placebo effect, this would be just a matter of people being ripped off, but long-term antibiotic use can have quite nasty health consequences. What makes matters far, far worse is that medically ignorant politicians have placed this likely nonexistent medical condition on the statute books. Connecticut, California, Massachusetts, and Rhode Island have laws that protect physicians, no matter how negligent or incompetent, who diagnose this mystery disease and prescribe long-term antibiotics for it from being sued by patients or their families. These are quacks’ charters.
Mystery syndromes are nothing new. One unusual medical offering is All About Radiation (1957) by L. Ron Hubbard and others.5 The text of this book, largely cobbled together from a quartet of lectures Hubbard gave on the subject, has been subject to some editing through its various editions. In their Devenez Sorciers, Devenez Savants (2002) Georges charpak and Henri Broch reproduce a salient paragraph (p. xiii of US edition):
At what point is radiation harmful to the human body? No one knows, but we can state the following: a wall fifteen feet thick can’t stop a gamma ray. On the other hand, a body can. Which leads us to pose this medical question, of the greatest significance: why can gamma rays go through walls but not through the body? Clearly, a body is less dense than a wall. As we do not find an answer in the material domain, we must therefore enter the mental domain.
This is, obviously, nonsense. Earlier versions of Hubbard’s text continue: “I can fortunately tell you what is happening when a body gets hurt by atomic radiation. It RESISTS the rays! The wall doesn’t resist the rays and the body does.” Hubbard’s most astonishing claim is that radiation sickness (and indeed some cancers) can be cured by dosage with a tonic called Dianazene, devised by one L. Ron Hubbard.
Hubbard is described on the cover of later editions of All About Radiation as a nuclear physicist—indeed, on the dust flap of some editions we’re told he was “one of America’s first nuclear physicists”—curious, in that Hubbard wasn’t any kind of physicist at all. In 1931 he briefly attended a course in nuclear physics at George Washington University; he received an F and dropped out. His medical qualifications consisted of a “PhD” from “Sequoia University”—a notorious diploma mill that in 1984 would finally be closed down by court order. In 2009 a Freedom of Information request in the UK revealed that Sequoia University had in fact been owned by . . . Hubbard himself.
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It’s a sad but generally accepted fact of medical science that in only about 15 percent of cases is there evidence that the “scientific” part of the treatment has actually done any good.6 The rest is down to the placebo effect, or to the body’s ability to cure itself of most ailments, or to the patient’s trust in the doctor, and so forth. Thus, a purveyor of fake medicine may be able to record a modest success rate in treating certain ailments.
In blind trials of new drugs, it emerges pretty consistently that about 30 percent of the people who’ve been receiving the placebo feel better as a result. Thus, the average CAMster can expect a roughly 30 percent success rate even before other factors kick in. However, despite the power of the placebo effect, we really don’t understand it. For example, it’s been found that the effectiveness of a placebo is influenced by the form in which it’s delivered: pill, capsule, liquid or, generally best of all, injection (there are cases of military surgeons in war zones who, bereft of anesthetics, have injected saline water to great anesthetic effect). With pills and capsules, such seemingly ephemeral matters as color and shape are important. Taking two placebo pills a day works better than taking just one. And as a general rule expensive placebos work better than cheap ones.
One of the most startling results to emerge in recent years is that Valium® (diazepam), for many years the mainstay of outpatient anxiety treatment—the “Mother’s Little Helper” of the Stones song—works only if the patient knows it’s being administered;7 its beneficial results in relieving anxiety would thus appear entirely the product of placebo, even though untold millions will attest that Valium worked for them.
There was some media excitement over the 2010 paper “Placebos without Deception: A Randomized Controlled Trial in Irritable Bowel Syndrome,”8 for which a team gave thirty-seven of eighty sufferers from IBS a placebo while the other forty-three sufferers received no treatment. What made this study unusual was that the patients receiving the placebo were told this was what they were being given; the pills were actually labeled “placebo.” According to the team’s public pronouncements (simplifying the more cautious claim made in their paper), nearly 60 percent of the patients receiving the placebo felt better, while just 35 percent of the others reported an improvement.
On face, this seems pretty convincing evidence that the placebo effect works even with patients who know what’s going on. There were, however, some problems with the study.9 First, the researchers recruited subjects using advertisements that talked of “a novel mind–body management study of IBS”—so the subjects were likely to be predisposed to a favorable result. Second, the efficacy of the treatment was judged merely by asking the patients if they felt better. Third, by its very nature, the study couldn’t be blinded—far less double-blinded. And then there was the matter of how the placebo group was introduced to the concept of placebos:
[P]atients were told that “placebo pills, something like sugar pills, have been shown in rigorous clinical testing to produce significant mind–body self-healing processes.”
The basis for the placebo effect in ordinary circumstances is that patients are being given pills they’re told will help them. This is exactly what the researchers did here. What they studied, then, was really little more than a standard case of the placebo effect at work.
A 1985 estimate10 suggested that 35 to 45 percent of medical prescriptions offer placebos, whether the prescribing doctor knows this or not. Some are for drugs that are valid, but not for the patient’s particular condition; others are for harmless compounds. Many GPs (general practitioners) openly admit that a large part of their practice is “placebo medicine” . . . although it’s probably a good idea not to ask your own if this is the case. In addition, we all prescribe medicines for ourselves for minor ailments—aspirin from the bathroom cabinet, perhaps—that may often have only a placebo function. In so doing, we perhaps relieve just slightly the pressure on public healthcare systems whose restricted resources might be better spent elsewhere. And it’s in this very limited sense, too, that CAM can be useful: Thanks to the placebo effect, a herbal infusion is likely to do as much for your cold as a prescription drug, and you’ll be saving your GP some time. Although, of course, if you’re wrong about your ailment being trivial . . .
Saying that CAM often works just as well as scientific medicine because of the placebo effect is one thing, portraying scientific medicine as a dangerous killer is another, yet this is exactly what Gary Null, Carolyn Dean, Martin Feldman, Debora Rasio, and Dorothy Smith did in a report called “Death by Medicine”11 that was published by the online magazine Life Extension in March 2004 and later expanded as the book Death by Medicine (2010) by Null and Feldman. They produce some impressive-looking figures for the casualties caused by medical intervention, from diseases caught by hospital patients to bedsores. Bedsores? Yes, sometimes people in hospitals and nursing homes suffer from bedsores. Of course, bedridden patients tended at home by untrained family members are even more likely to develop bedsores. And merely pointing out that drugs can have side effects while ignoring all the beneficial effects they can have is like wringing your hands about how many people drown annually without mentioning that water is in many other respects jolly useful stuff.
Although the problem of iatrogenic infections is not a trivial one, it tends to be blown up out of all proportion by sensationalist media coverage. In Bad Science (2009) Ben Goldacre describes (pp. 279–89) the 2005 scare fomented in the UK by the tabloid media over MRSA (multidrug-resistant Staphylococcus aureus), a particularly nasty bug that was said to be rife in the country’s hospitals. Investigative reporters, in search of scoops, would infiltrate hospitals and take swabs of likely looking surfaces. Traces of MRSA were found aplenty . . . but only when the swabs were sent for analysis to a particular lab, chemsol Consulting, which proved little more than a one-man operation run by a good-intentioned amateur out of his garden shed. Swabs sent elsewhere almost without exception came back with a clean bill of health. The response of the tabloid journalists was not to query chemsol’s competence but to stop sending their swabs to the other labs!
Still rumbling is the panic over fluoridation of water supplies, a measure proven to reduce caries in both adults and children. Part of the concern is over the fact that fluorine is a highly reactive element; do we really want to be drinking its compounds, the fluorides? Since fluorides occur naturally in many water supplies, this would seem a bit of a nonconcern; so far as fluorine’s reactivity goes, sodium and chlorine are likewise highly reactive elements, yet we happily season our foods with sodium chloride. There can be, especially if the fluoridation in a local water supply has been overenthusiastic, a side effect called fluorosis, whereby the teeth become mottled, but this isn’t especially common and seems a small price to pay. Other theorists claim fluoride is really a mind-control drug designed to make us all more vulnerable to the brainwashing efforts of those intent on imposing a One World Government . . . This was approximately the attitude of the John Birch Society, one of whose founder members was none other than the father of David and charles Koch, who today are in the forefront of efforts to deny climate change (see pages 274ff.).
In April 1999 the Centers for Disease Control’s Morbidity and Mortality Weekly Report listed the fluoridation of drinking water as one of its “Ten Great Public Health Achievements—United States, 1900–1999”12 alongside such other items as vaccination and recognition of smoking as a health hazard.
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The original snake oil, shéyóu, was probably fairly efficacious. It was oil from the fat sac of a particular type of sea snake, extracted by chinese physicians for use in the treatment of arthritis. Sea snake oil, like fish oil, is rich in omega-3 fats, and ingesting these has a beneficial anti-inflammatory effect.
However, this is not the snake oil whose use has given the language a synonym for quack medicine. The entrepreneur concerned, one Clark Stanley—the so-called Rattlesnake King—presented his Stanley’s Snake Oil at the 1893 chicago World Fair, demonstrating its means of preparation: Take your rattler, slit its belly open, throw it into boiling water, cream off the fat that rises to the surface, and, bingo, you have a liniment suitable for treating a range of joint ailments, toothache, sore throat, frostbite . . . The trouble is that this isn’t how Stanley’s Snake Oil was prepared; he was just being a showman. When the feds finally got around to testing the stuff in 1917 they found it contained no snake oil; it was a mixture of ingredients like turpentine, camphor, red pepper, mineral oil, and a small amount of animal fat (probably lard). Curiously, this might have had some useful effect as a liniment—unlike actual rattlesnake oil. As rattlesnake oil is deficient in omega-3s, there’s no point in swallowing it, either.
Of course, nowadays none of us are fool enough to fall for things like snake oil; we opt for CAM therapies instead. Even if we know enough to steer clear of those, many of us, distrusting the activities of Big Pharma, will gobble vitamin pills and supplements. Rather than listen just to our GP, we’ll quite happily accept the advice of nutritionists who recommend—and often then proceed to sell us (not cheaply)—their own lines of vitamins and supplements. What we don’t realize is that, whether or not they’re really the baddies beloved of screen and printed thrillers, the folks in Big Pharma aren’t necessarily mugs. chances are the company that makes those very vitamins and supplements you’re buying is owned by Big Pharma.
Perhaps the most dangerous US law ever passed has been the Dietary Supplement Health and Education Act of 1994. In consequence of this act, the FDA has no control over the contents of that brightly colored bottle of tablets or capsules you find in your supermarket. It is solely the responsibility of the manufacturer as to whether their pills contain what the label says, in the quantities indicated on the label, and prepared with any acceptable level of hygiene. Quite literally, vitamin tablets could contain cyanide, and could be known to contain cyanide, and yet the FDA would be powerless to stop the marketing exercise until people started dying.
There is one area of very slight control. When the labels make claims about the capabilities and efficacy of their products—“Effective against All Known Forms of Cancer,” for example—they must include also a caveat, somewhere in the blur of small print, to the effect that “[t]hese statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.” But who reads the small print? Besides, the manufacturers try to make sure you don’t. To get an accurate version of the wording, I grabbed a bottle produced by those friendly folk at Sundown. I had to use a magnifying glass just to find the caveat.
The net result is that, while prescription drugs are (rightly) highly regulated and can be pulled off the market as soon as it’s discovered they’re toxic, and “traditional” medicines and supplements can contain, to pick a single example, heavy metals known to accumulate in the body and eventually cripple and kill (a 2004 report published in the Journal of the American Medical Association13 discovered that about 20 percent of the Ayurvedic herbal medicines sold in Boston-area South Asian grocery stores contain lead, mercury, and/or arsenic at potentially harmful levels), large sections of the US public believe the unregulated stuff safe and the prescription drugs dangerous. A further unrecognized consequence is the death toll of consumers bamboozled into believing they’re effectively treating their ailments through supplements and therefore refusing medical treatments that might have saved their lives.
The Dietary Supplement Health and Education Act, which was heavily lobbied by the supplements industry, was presented to the US Senate by Orrin Hatch (R-UT), Harry Reid (D-NV), and Frank Murkowski (R-AK). No one can guess how many lives have been lost as a result of it. As Dan Agin remarks in Junk Science (2006, p. 120), “We have struggled through thousands of years of medical history, acquiring scraps of medical know-ledge piece by precious piece, and to have this struggle and its fruits tossed aside for the sake of a so-called free market economy is an intellectual travesty that ultimately causes hardship, pain, and death.”
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So the “double helix” of information in the heart of all reproductive cells is made up from 64 hexagrams, as in the I-ching. Could this really be just coincidence?
—Colin Wilson, From Atlantis to the Sphinx, 1996
In Not in Kansas Anymore (2005) christine Wicker tells of a magician called Daniel who first became seriously interested in magic during his schooldays because of a local woman who could heal cuts: “It was a very eerie thing to see, more so to actually feel if she was working on you. If you had a deep cut, she could hold her hands over it and chant a sort of prayer or bunch of syllables and the bleeding would stop, and it would sort of pull itself back together over the course of ten minutes or so” (p. 196)—all of which sounds rather impressive until you realize that minor cuts usually stop bleeding fairly soon if merely left to their own devices. But clearly Daniel preferred, consciously or unconsciously, the magical explanation to the mundane one. The woo-ness of the “sort of prayer or bunch of syllables” was actually a factor in convincing him there was something genuine at work. Over and over again when reading about medical woo we see this; the stark implausibility is one of the attractions. “You’ll barely believe this, but old Mr. Benson could hardly walk because of his sciatica until he ate a pack of virgin tarot cards under the full moon, and he’s not felt a twinge since.”
In his book Superstition (2008) Robert Park discusses “energy-healer” Adam McLeod, who works under the nom d’huil de serpent Adam Dreamhealer and has the honor of a testimonial from paranormal investigator and ex-astronaut Edgar Mitchell, who reckons Dreamhealer remotely cured him of his kidney cancer. Dreamhealer uses a technique he calls quantum holography to visualize people’s cancers and make them go away. If this doesn’t work the first time, he’s willing to have another try—for a repeat fee, of course. Like a surprising number of other woo therapists, Dreamhealer doesn’t need a physical consultation for diagnosis, nor even for treatment: he can tweak your quantum hologram just fine while looking at a photo.
He apparently discovered his psychic powers as a teenager, when he experienced various involuntary telekinetic events—a better excuse than most teens can produce to explain how the car got scratched. After he’d cured his mother of trigeminal neuralgia he had a dream in which a huge black bird told him to go to Nootka—which proved to be an island in British Columbia. Off went the family to Nootka, and Dreamhealer met the huge bird in real life. It responded by downloading all the information in the universe into his brain. Oh, my.
Park’s involvement began when ABC Primetime wanted him to consult on a program about Dreamhealer. Had the makers ensured, he asked, through medical records or biopsies, that Dreamhealer’s “patients” had had cancer to begin with? The producers were startled; this hadn’t occurred to them. Because they had no time to carry out the review Park suggested, they ran the documentary without, although they did craft it as an exposé—as well they might, since Dreamhealer failed to deliver the goods in any of the test cases they offered him.
As Park points out, Dreamhealer must have cried all the way to the bank. If only a tiny percentage of Primetime’s audience dissented from the documentary’s debunking conclusions, this still represented many thousands of potential clients who would otherwise never have heard of him.
Of all the scientific research that’s been carried out into woo medicine, one paper stands out. Called “A Close Look at Therapeutic Touch” and published in 1998 in the Journal of the American Medical Association, it detailed how its author, Emily Rosa, had devised an experiment to test the ability of healers to detect the energy field surrounding her hand. She found that ability lacking in the twenty-one she tested. The paper is still regarded as science’s definitive verdict on therapeutic touch. The researcher, Rosa, devised and executed the experiment at its heart two years earlier, in 1996 . . . for her school’s science fair, when she was nine years old.