I Think You'll Find It's a Bit More Complicated Than That (32 page)

This was an era when serious people took bullshit more seriously. While today homeopathy is taught in universities eager to serve popular demand, the most notable predecessor to Gardner’s
Fads and Fallacies
was
Higher Foolishness
, written in 1927 by David Starr Jordan, the first president of Stanford University. The American Medical Association campaigned hard against press publicity for quacks, and bullshit seemed more pressing. There were signs of a relapse into religious fundamentalism, driven in part by bizarre beliefs such as Velikovsky’s, and the indulgence of pseudoscience was playing its part, live and in colour, in some very bad situations.

The bizarre racial theories of the Nazi anthropologists were fresh in the memory, and in Russia things were little better. During the 1930s, communism had turned its back on evolution and Mendelian inheritance, preferring the theories of Trofim Lysenko on the inheritance of acquired characteristics, which sat better with its notions of heritable self-improvement. Sadly, Lysenkoism ran contrary to the experimental evidence, and could only be maintained by sending Russia’s geneticists to die in Siberian labour camps, so that by 1949 Russian children were being taught that the revolution had shattered the hereditary structure of the Soviet people, with each generation growing up finer than the last as a result.

But alongside concrete outcomes like death camps, Gardner never loses sight of the parallel tragedy.
Harper’s Magazine
– notable for its recent promotion of
Aids denialism
– was then pushing Gerald Heard’s book
Is Another World Watching?
, which explained that tiny flying saucers have visited earth, piloted by two-inch super-intelligent bee people from the planet Mars. At a time when the shelves were filled with magazines called things like
Life
,
True
and
Doubt
, a widespread passion for knowledge was being regularly derailed into nonsense.

So, Gardner has the same fun we have with the homeopaths (while complaining that Marlene Dietrich is a fan), the vitamin-pill peddlers, the anti-vaccination campaigners and the chiropractors, and above all captures their character, which endures: the self-imposed isolation from the corrective of academic criticism, the persecution complex, the grandiosity, the denouncement of critics as being in the pay of darker forces, and the enjoyment of jargon like ‘electroencephaloneuromentimpograph’, a machine devised by the son of the founder of chiropractic.

I have a copy of the first edition of
In the Name of Science
(they’re cheap), but subsequent editions are much more desirable, because they include a supplementary introduction where Gardner takes delight in his hate mail, and especially the mutual indignation that each target expresses at being unfairly associated with the others, whom they regard as the true charlatans.
¹
In sixty years nothing has changed. The best we can hope for is the simple, enduring pleasure of baiting morons.

How Do You
Regulate Wu?

Guardian
, 20 February 2010

You might have read about the case of
Ying Wu
this week: a fully qualified traditional Chinese-medicine doctor operating out of a shop in Chelmsford who for several years prescribed high doses of a dangerous banned substance to treat the acne of senior civil servant Patricia Booth, fifty-eight, reassuring her that the pills were as safe as Coca-Cola. Following this her patient has lost both kidneys, developed urinary tract cancer, had a heart attack, and is now on dialysis three times a week. Judge Jeremy Roberts gave Wu a two-year conditional discharge, saying she did not know the pills were dangerous and could not be blamed, because the practice of traditional Chinese medicine is totally unregulated in Britain, a situation which he suggests should be remedied.

This sounds attractive, and has been loudly welcomed by alternative therapists, who see regulation as the path to legitimacy. It’s worth noting, in passing, that we do already have systems in place for dealing with dangerous substances (these pills are banned), false claims on the high street (like the regional Offices of Fair Trading, which chose not to use its powers here), and people prescribing treatments which have both powerful effects and dangerous side effects (like doctors, who make bad calls often enough that it’s hard to imagine why you’d want people with weaker training handing out dangerous pills).

But special regulation for alternative therapists raises one very simple problem: it’s extremely hard to regulate practitioners who make claims based on faith more than evidence. In such a situation, what is your yardstick for whether a clinical decision was reasonable?

Current attempts at regulation have exposed these contradictions. The Complementary and Natural Healthcare Council (or OfQuack, as it is affectionately known) has a Code of Conduct which forbids alternative therapists making claims without evidence. Blogger Simon Perry complained about every single reflexologist on its register, on the day they joined, if they were claiming to treat things like arthritis, infertility,
babies with colic
, and so on. All were told off, but the CNHC decided that their fitness to practise was not impaired, because its reflexology expert said that the practitioners would have honestly believed their claims to be reasonable, since they would have been trained to believe that they could treat these complaints.

So is the training the problem? The government’s review into regulation of alternative therapists has recommended that it should be compulsory to have a university degree in alternative therapies, and that universities should run such courses. And what is taught on these courses? You cannot know, because the universities have gone to
shameful lengths over many
years, to the point of multiple
appeals at the highest level
with the Information Commissioner, to keep the contents of these science degrees a closely guarded secret.

I and Professor David Colquhoun of UCL have obtained occasional course materials from students themselves, who thought they were going to be taught the scientific evidence base for alternative medicine, and have been dismayed by what they received. You can see why the universities wanted to hide them. Handouts from the
Bachelor of Science degree
in Chinese Medicine at Westminster University, for example, show students being taught – on a science degree – that the spleen is ‘the root of post-heaven essence’, ‘houses thought (and is affected by pensiveness/over thinking)’ and is responsible for the ‘transformation of qi energy’, ‘keeping the muscles warm and firm’.

‘Marrow helps fill the brain’. ‘Sin Jiao assists the lungs’ “dispersing function”, spreading fluids to skin in form of fine mist or vapour (so it helps regulate fluid production …)’. We also see the traditional anti-vaccine rhetoric – a core marketing tool for alternative therapists – as students are taught that vaccination is a significant cause of cancer.

One lecture by Niki Lawrence on ‘Herbal Approaches for Patients with Cancer’, meanwhile, discusses the difficulties of the Cancer Act, which was specifically designed to protect patients from the more dangerous extremes of alternative therapists’ self-belief. ‘Legally you cannot claim to cure cancer,’ it begins, on a slide headed ‘Cancer Treatment and the Law’. ‘This is not a problem because: we treat patients not diseases.’ Niki then romps on to explain that poke-root is ‘especially valuable in the treatment of breast, throat and uterus cancer’,
Thuja occidentalis
is ‘indicated for cancers of possible viral origin, e.g. colon/rectal, uterine, breast, lung’, and
Centella asiatica
‘inhibits the recurrence of cancer’.

It is a tragedy that someone has contracted a fatal condition and is on dialysis. What worries me is that when you try to slot the square peg of fanciful overclaiming and faith-based medicine into the round hole of serious regulation and university teaching, you create more problems and confusion than you started with.

Blame Everyone
But Yourselves

Guardian
, 26 July 2008

Like the practitioners of many professions that kill with some regularity, doctors have elaborate systems for seeing what went wrong afterwards. The answer is rarely ‘Brian did it.’ This week the papers have been alive with criticism of quack nutritionism after the case of Dawn Page, a fifty-two-year-old mother of two who ended up being treated on intensive care, with seizures brought on by sodium deficiency, and left with permanent brain damage. She had been following the advice of ‘nutritional therapist’ Barbara Nash. Ms Nash denies liability. Her insurers paid out £810,000.

I will now defend the nutritional therapist Barbara Nash.

There is no doubt that people who declare themselves to be healthcare practitioners are a risk, by virtue of their sheer, uncalibrated self-belief. It must take strong nerves to tell a customer, as they follow ‘the Amazing Hydration Diet’ – dramatically increasing water intake, and reducing salt intake – that their uncontrollable vomiting is simply ‘part of the detoxification process’. Perhaps it was done with the reassuring tones of a clinician. In fact, Mrs Page’s lawyers explained, at this point she was told by Ms Nash to increase her water intake to six pints a day.

But I put it to the kangaroo court of the international news media – since this story has now spread as far as America and Australia – that Barbara Nash’s confidence in her own judgement cannot be viewed outside its social context.

After completing the rigorous training at the ‘College of Natural Nutrition’, anyone would naturally believe themselves to be appropriately qualified, and able to give advice confidently. That is certainly the impression I have from reading the college’s website. Barbara Nash’s confidence in her own abilities seems entirely congruent with that world view. This college operates legally and is well promoted.

Then there are the professional bodies. They have been rather keen to distance themselves from Barbara Nash.
In the
Daily Telegraph
, for example: ‘The British Association for Applied Nutrition and Nutritional Therapy (BANT) which has its own code of conduct, said Mrs Nash was not a member.’ This is not the entire truth. Barbara Nash is
advertised on yell.com
as a member of BANT. In fact, she was indeed a member of BANT, until last year.

Membership of BANT
carries such privileges
as ‘a listing in the BANT Directory of Practitioners, which is available to the public, and entry on the BANT website’, and ‘acknowledgement of professional status by the Nutritional Therapy Council’. Endorsed in this way by these bodies, Barbara Nash has every reason to hold her own clinical abilities in high regard. The episode with Dawn Page on intensive care occurred in 2001. These honours were conferred upon her by BANT in 2005.

And of course we should not forget the wider social context: food has become the
bollocks du jour
, with no regard for accuracy whatsoever. This month, the
Daily Telegraph
was printing advice from a self-declared nutrition therapist on folic acid in pregnancy that may actually increase the risk of disabling neural-tube defects in babies, in the same week that it ran a news story telling women that red wine prevents breast cancer, when actually it increases it; and the sofas of daytime television are filled with self-declared nutritionists, because they give us what we want to hear: technical, complicated, sciencey-sounding health advice.

Looking at Barbara Nash’s website, I see she
carries testimonials
from her own appearances on ITV Central’s
Shape Up for Summer
slot: ‘When I met Barbara [who was the nutritionist for this programme] I wasn’t really sure how her eating plan would help me … However, it did involve one aspect that I found very difficult to follow, drinking four pints of water a day. I would be the first person to say that I was sceptical but as I had volunteered to take part, I felt that I at least owed it to everyone to try. Was I surprised by the results!’