Some people are deeply moved by the idea that there is a more holistic way of viewing human health, that there is a warm, friendly alternative to cold, institutionalized medicine as I learned while conducting interviews for a new "e-monograph" about unconventional medical practices.
But just because an idea is pretty doesn't mean it's true. That's a lesson smart children learn early on, perhaps upon discovering that there's no Santa Claus or upon realizing that the neighbor kids were lying when they said they had some wonderful magic beans.
We must be suspicious, then, of claims that are pretty but unscientific even ones that seem intuitively plausible. Given the complexity of medicine, there is plenty of room for error as we try to separate real physical causation from the so-called placebo effect, the tendency of patients to report that their conditions are improving when in fact the patients are merely in a more pleasant, optimistic mood because they believe they have received a beneficial treatment. Today's good mood could be tomorrow's inoperable tumor if we let optimism take precedence over tangible physical results.
We must be even more suspicious of claims that seem designed precisely to prevent us from testing whether a treatment is physically effective or is merely a stimulus to the imagination though we might be wise to harness the power of suggestion, if it diminishes pain and distress. Much of what is called alternative medicine appears calculated to make only safe, vague promises (such as curing "low energy" or "enhancing the immune system") that suggest no clear criteria for judging efficacy but put believers in a positive frame of mind.
Finally, we should be most suspicious of treatments that sound disarmingly nice, are likely to have at least some placebo effect, and come packaged as so much of alternative medicine does with a built-in list of excuses explaining why mainstream science cannot confirm any of the treatments' supposed benefits.
One might be willing to defer to tradition, folk wisdom, or the advice of a guru about a treatment as long as its practitioners were willing in principle to subject their claims to rigorous tests, but these days alternative medicine comes with a readymade philosophy (about the corrupt nature of medical journals, hospitals, and mainstream science) that is little better than a grand conspiracy theory aimed at deflecting all criticism. Under the standard version of the theory, pharmaceutical companies are trying to keep us all ill so they can keep selling us more shoddy products and they pay off doctors and major medical journals to play along. Despite the great diversity of views in science and medicine and the competition to announce breakthroughs, we are expected to believe that virtually no doctor or researcher is willing to break ranks and tell the truth about alternative medicine. They're all dupes, apparently.
Explanations or Excuses?
It's a conspiracy theory designed to appeal to anyone who has been treated badly by a mainstream doctor, had an unpleasant stay in the hospital, or suffered side effects from medication, which is a lot of us. The theory is especially appealing to those who are already suspicious of the establishment such as latter-day hippies, religious zealots, and anti-FDA crusaders (all of whom have their good points but don't always make scientific objectivity their top priority).
What if such folk turned upon alternative medicine just a tenth of the suspicion that they normally focus upon the establishment, though? They might realize that mainstream medical journals aren't rejecting reports of alternative medicine's efficacy due to a desire to protect the pharmaceutical industry or scientific dogma but due to the failure of most defenses of alternative medicine to rise to minimum accepted levels of professionalism.
However, in spite of alternative medicine's philosophical errors (and the health risks they create), I decided to take a sojourn in the world of the believers, to do my level best to set skepticism aside and try to see the appeal of this very different approach to health. At the risk of offending both practitioners and critics of alternative medicine, both defenders and subverters of the establishment, I decided to talk to hypnotists, homeopaths, energy healers, and others, seeking some kernels of useful wisdom while exposing ample silliness.
From a New Age expo in San Francisco to alternative medical institutes in Santa Fe to voodoo-loving New Orleans, I trekked in search of some redeeming aspect to the whole alternative medicine phenomenon. I think the lesson I drew from all those strange experiences was this: With alternative medicine practitioners so often claiming that the mind can heal and skeptics so often saying that reported cures from alternative medicine are really all in the patients' heads, it would seem that there is some common ground here. Perhaps we can find a way to salvage alternative medicine's mood-altering effects without wasting money on its potions, crystals, and odd dietary regimens.
Or maybe I was wandering in the wilderness for too long. Check out my account and tell me what you think.
Responses:
September 30, 2002 Todd, I just wanted to congratulate you on a well-written and very enjoyable article on your alternative medicine experiences. As a journalist and skeptic, I am also concerned about the impact of herbal medicine and snake-oil salesmen. One of my best friends, a very intelligent girl with a logical mind, recently consulted the services of a clairvoyant and a "coffee cup reader," who apparently reads the dregs at the bottom of your cup. She was the last person I thought would do something like this. She had some relationship issues and this coffee-cup reader apparently helped her. I realized my friend was really seeking a non-mainstream psychologist. For her it would be embarrassing to visit a "real" psychologist (we're in Australia therapy hasn't reached the trendy stage yet), so the dreg reader was a safe alternative. It's no different from the people who phone up radio announcers and reveal the most intimate details of their lives to complete strangers. As a former broadcaster, I was always amazed by this phenomenon. And it's not just lonely old people who phone you. I once had a woman phone and tell me about her gynecological problems while her family watched TV in the next room! Another intelligent friend of mine who has chronic fatigue refuses to see doctors anymore because they tell him there's nothing wrong with him. He does not look well I can vouch for that. Now he sees only naturopaths who tell him to eliminate whole food groups from his diet. I can only hope he doesn't develop osteoporosis. But these people have a deep dissatisfaction with the way doctors have treated them. Your conclusion that these alternative therapists provide a better bedside manner is right on the money in more ways than one! Doctors should learn to give better customer service. I recall several occasions where a doctor was indifferent to me and I walked away angry. But I still wouldn't seek the advice of a naturopath. I simply found another doctor, just as I would find a better hairdresser. I once joked to a colleague that people would hang dog droppings around their necks if some "healer" with an astrological-sounding name said it cured all ills. Sadly, I'm not wrong. Cheers, Kerryn Marlow December 9, 2002 I would like to make a comment about homeopathic treatments. They do work. I have successfully used them for years. It isn't just my imagination, either, because they also work on my dogs. The dogs can't be fooled by trickery. The dogs get well from allergy attacks, sore throats, coughs, etc. Thanks, Diane Seavey replies: Of course, the efficacy of the treatments on dogs, too, should be shown through clinical trials, to avoid the possibility that Rover is responding to upbeat or downbeat body language and verbal cues from you (since you are probably happier after starting Rover's treatment) and to avoid the possibility that you are subjectively misjudging Rover's symptoms. How exactly does one know that a dog has a sore throat, for example? Septmeber 1, 2003 Todd, I enjoyed your recent article in the Skeptical Inquirer on Santa Fe. I've spent time there, and in Taos, where the harmonic convergences actually produce vibrations that can be felt by skeptics. But that ain't nuttin' (as we say in Arkansas) you need to go check out the New Age psychobabble in Sedona, Arizona. And tell your sponsors that you need a buttload of money to cover it correctly. That is one expensive town. The locals blend ancient Indian lore, 60s hippie stuff, and more modern New Age stuff to attract visitors. Some of this has been reported in Arizona Highways, although they downplay the nutcase factor. There are these towers of red clay buttes that shoot up around the town. The buttes are really beautiful. Supposedly, if you take a compass into the middle of town, the arrow will start spinning around because of the magnetic forces of the buttes' vortices powers. I don't pretend to understand what that means, but my buddy and I put his watch down in the middle of town (he had a compass on his watch) and the north arrow pointed toward Montana. On that particular day, Montana was still pretty far north of Arizona. Keep up the good work. Mark March 3, 2004 Hi, Todd: I was catching up on my reading and came across your Skeptical Inquirer article about Santa Fe. You cited a homeopath as indicating that, "ironically, it was the Communists' Cultural Revolution of the 60s and 70s that steered China's doctors toward American-style, more materialistic medicine." You didn't comment on this. But Stoller (the homeopath) got it wrong: exactly the reverse was true. In an effort to bring Chinese science into the twentieth century the Kuomintang had outlawed acupuncture and other folk quackeries in China. Then along came Chairman Mao, who was the world's champion murderer. He killed some thirty million of his fellow countrymen, more than Hitler or Stalin. He killed off the affluent, the educated, anyone he thought might stand in the way of achieving his worker's paradise. And he woke up one morning to find that he had no doctors left in China: he had killed off just about every one. What to do? So he organized cadres, mostly of young women, gave them copies of the Little Red Book (sayings of Chairman Mao), and taught them basic first aid and folk medicine, including acupuncture. Then he sent them off to the boondocks to provide comprehensive care for his liberated masses. And that's how acupuncture (and the rest of folk medicine, including the herbs, dried lizards, and shark entrails) came back in force to China and, ultimately, got to the rest of the credulous world. Regards to everyone. Dr. Marvin J. Schissel |