Killing Us Softly (25 page)

Another example of the potential value of placebos is homeopathic remedies.

In March 2011, Mehmet Oz invited a homeopath named Russ Greenfield onto his show. Oz began by saying that his wife gives homeopathic medicines to their children all the time. “It's only when they don't work that she calls me,” he said. Homeopathy is based on the notion that if you take a particular medicine and dilute it to the point that not a single molecule remains, the water will “remember” that the drug was there. (Given the finite amount of water on earth, it's comforting to know that water doesn't really remember where it's been.) Greenfield explained that the “spirit of the medicine was there.” A win-win situation. People can enjoy the benefit of a drug without having to suffer any of its side effects (since it's not there anymore).

Oz described homeopathy as medicine present in “very small diluted amounts”—so dilute, you can “hardly find a molecule.”
He showed his viewers two large jugs of fluid. One, a frightening red color, was labeled “Conventional Medicine.” The other, containing only water, was labeled “Homeopathic Medicine.” Oz filled a dropper with red fluid from the “Conventional” jug and added it to the “Homeopathic” jug, which turned faintly pink. This, he declared, was the basis of homeopathy. Any reasonable viewer would assume that homeopathic medicines are weak preparations of conventional medicines. But they're not. It would have been more accurate if Oz had taken a dropper full of air, added it to the “Homeopathic” jug, and said that homeopathic medicines don't contain any medicine at all. Not surprisingly, homeopathic remedies haven't been found to be more effective than sugar pills or water. (After all, they
are
sugar pills or water.) Five excellent studies have shown that homeopathic remedies didn't treat cancer, attention deficit/hyperactivity disorder, asthma, dementia, or flu-like symptoms. But again, just because a drug doesn't work better than a placebo doesn't mean it doesn't work. It only means that it isn't better than the placebo response.

For example, one popular homeopathic remedy is oscillococcinum, promoted for the treatment of flu. Homeopaths make oscillococcinum by homogenizing the heart and liver of a Burberry duck, diluting it in water one-hundredfold, and repeating the hundredfold dilution two hundred times. A solution this dilute doesn't contain a single molecule of the Burberry duck. In fact, the preparation is so dilute that not a single molecule of the duck would be found if the final volume were that of the universe. The duck is gone. From a scientist's standpoint, oscillococcinum is one gram of sugar.

Although oscillococcinum is inert, it's a lot better than other
remedies out there, many of which are quite harmful. In 2007, the FDA issued a warning against the use of cough-and-cold preparations in young children—a warning long overdue. Between 2004 and 2005, the CDC found that more than fifteen hundred young children had suffered hallucinations, seizures, and heart problems caused by cough medicines containing stimulants like pseudoephedrine. Three children had died as a result. Worse: cough-and-cold preparations do little to relieve symptoms.

Oscillococcinum, on the other hand, doesn't cause any of these problems. And although it works no better than a gram of sugar, many people—possibly benefiting from the placebo response—believe that it does. Most important, it avoids the harm caused by medicines that are all too available over the counter.

A
lthough these therapies are often referred to as “New Age” medicine, there's nothing new about them. Healers have been selling the placebo response for five thousand years. The Ebers Papyrus, written in 1500 B.C., contains more than seven hundred drugs of mineral, vegetable, and animal origin. Treatments included dirt and flyspecks scraped off walls; blood from lizards and cats; fat from geese, oxen, snakes, mice, hippopotamuses, and eunuchs; dung from pigs, dogs, sheep, gazelles, pelicans, and flies (this couldn't have been easy); and ram's hair, tortoise shells, swine's teeth, donkey's hooves, and grated human skulls. Again, just because pelican poop doesn't contain real medicine doesn't mean it didn't work to treat pain, fatigue, and heartburn 3,500 years ago. The placebo response
is a powerful thing. And back then it was all they had. Now, because we have medicines that are much better than placebos, we often ignore the placebo response. To their credit, alternative practitioners haven't. It would be of value, however, if they could learn to do it without the pills, needles, electrical devices, and appeals to magical thinking.

O
ne of the greatest proponents of alternative medicine was Norman Cousins, longtime editor of the
Saturday Review
. Cousins suffered from joint and muscle pain, which he believed was cured by his indomitable will to live and laughing at Marx Brothers movies. (“There ain't much fun in medicine,” wrote Josh Billings, an American humorist, “but there's a heck of a lot of medicine in fun.”) Like Art Caplan, Cousins reasoned that the placebo response could be elicited
without
placebos. He wrote about his experiences in
Anatomy of an Illness
, a national best seller in the late 1970s: “The placebo is only a tangible object made essential in an age that feels uncomfortable with intangibles, an age that prefers to think that every inner effect must have an outer cause. Since it has size and shape and can be hand-held, the placebo satisfies the contemporary craving for visible mechanisms and visible answers. But the placebo dissolves on scrutiny, telling us that it cannot relieve us of the need to think deeply about ourselves. The placebo, then, is an emissary between the will to live and the body. But the emissary is expendable.”

… So we must be careful about what we pretend to be.

—Kurt Vonnegut,
Mother Night

A
lthough alternative therapies can be valuable, a sharp line divides those who practice placebo medicine from those who practice quackery. The line is crossed in four ways.

First: by recommending against conventional therapies that are helpful.

For example, Mehmet Oz's publicizing Dr. Issam Nemeh's claim that faith healing can cure cancer was wildly irresponsible. Many children have died because their parents believed that prayer (not antibiotics) cured bacterial meningitis; or that prayer (not insulin) cured diabetic coma; or that prayer (not radiation or chemotherapy) cured lung masses.

Andrew Weil has also occasionally steered people away from effective therapies. In 1995, Weil wrote, “Western medicine's powerlessness against viral infections is clearly visible in
its ineffectiveness against AIDS. Chinese herbal therapy for people infected with HIV looks much more promising.” Weil's recommendation was unfortunate. Eight years earlier, antiviral drugs had been shown to decrease HIV replication, lower the amount of HIV in the bloodstream, and prolong the lives of AIDS sufferers. Chinese herbs, on the other hand, haven't been proven to do any of those things. Patients who choose Chinese herbs instead of antiviral medicines are making a choice to shorten their lives.

Asthmatics have also suffered. In July 2011, researchers at Harvard Medical School gave a group of thirty-nine asthmatics albuterol (a bronchodilator), a placebo, sham acupuncture, or nothing. Albuterol dilated breathing passages much better than placebos. Alternative healers who recommend placebos instead of bronchodilators for severe asthma are putting their patients at unnecessary risk. In 2006, a six-year-old boy with severe asthma was treated with a homeopathic remedy instead of the bronchodilator that would have saved his life. Homeopaths have recommended their products for other treatable diseases, such as cancer, malaria, cholera, and AIDS.

Chiropractors also put patients at unnecessary risk when they attempt to treat medical illnesses. For example, a chiropractor named Marvin Phillips convinced the parents of Linda Epping, a little girl with a tumor of her eye, that surgery was unnecessary. All she needed was to “chemically balance” her body with vitamins, dietary supplements, and laxatives. Within three weeks, the tumor was the size of a tennis ball: too late for surgery. In three months, Linda Epping was dead.

But when it comes to steering people away from modern science, perhaps no one has been more irresponsible than another of Mehmet Oz's “Superstars”: Joe Mercola, an osteopath from suburban Chicago. Mercola is against pasteurization (heating at 145 degrees Fahrenheit for thirty minutes), claiming that it makes milk less nutritious. In fact, pasteurization doesn't destroy critical nutrients in milk. It destroys bacteria like salmonella,
E. coli
, campylobacter, and listeria, which can cause severe and occasionally fatal infections. About two hundred people get sick every year in the United States from drinking raw milk or eating unpasteurized cheese.

Mercola also believes that vaccines are dangerous and should be avoided or delayed. In April 2011, he helped pay for an advertisement on the CBS JumboTron in Times Square promoting his website as well as that of a prominent anti-vaccine group. And he questions whether HIV causes AIDS. “Exposure to steroids and the chemicals in our environment, and the drugs used to treat AIDS, stress, and poor nutrition are probably the real causes,” he argues.

Furthermore, Mercola suggests that cancer can be treated with baking soda and coffee enemas, and he warns against mammography, offering his own special device to detect cancer, inflammation, neurological problems, and vascular dysfunction (for which he has received a warning letter from the FDA). On
The Dr. Oz Show
, Mercola said, “our model doesn't kill anyone,” which would be true, except that people can die from vaccine-preventable diseases or infections caused by unpasteurized products or denying that HIV is the cause of AIDS or treating cancer with baking soda and coffee enemas instead of medicines that work.

T
he second way that alternative healers cross the line into quackery is by promoting potentially harmful therapies without adequate warning.

Andrew Weil writes that kava (
Piper methysticum
) “relaxes muscles, promotes calm, and is non-addictive.” Seven years later, when kava was shown to cause severe liver damage, the FDA issued a warning against its use. Indeed, few consumers are aware of possible side effects from many supplements easily purchased over the counter.

Chiropractic manipulations also aren't risk-free. In the 1980s, a chiropractor named J. Richard Stober popularized a technique called Bilateral Nasal Specific (BNS) therapy. To properly align bones of the skull, Stober stuck balloons into the nose. In 1983, a baby died of asphyxiation from BNS. In 1988, school officials in Del Norte County, California, subjected children with epilepsy, Down syndrome, cerebral palsy, dyslexia, and other learning disorders to a technique developed by a New York City chiropractor named Carl Ferreri that involved squeezing the skull with both hands like a vise. Chiropractors also pressed their thumbs hard against the roof of the mouth and the eyes. One chiropractor, who did most of the treatments, said they “removed static from the nervous system.” Children were forcibly restrained as they cried, screamed, and struggled to free themselves. One experienced a seizure while he was having his eye “adjusted.” In 2010, Edzard Ernst, a professor of complementary medicine at the University of Exeter, in England, reviewed the medical literature and found
twenty-six deaths from chiropractic manipulations, almost all caused by ripping the vertebral artery in the neck.

E
rnst and Singh have paid a price for their criticisms of alternative medicine.

In 2005, Prince Charles—an advocate for homeopathy, acupuncture, herbal medicine, and spiritual healing—personally commissioned a report that claimed that alternative medicines would save the National Health Service up to £3.5 billion. By then, Ernst and his group had already published 700 papers showing that almost all alternative therapies didn't work better than placebos. Ernst described the report as “outrageous and deeply flawed.” In response, Sir Michael Peat, Prince Charles' private secretary, filed a complaint against Exeter University. In 2011, when Prince Charles promoted Duchy Herbals Detox Tincture—a remedy made from artichoke and dandelion extracts—Ernst called him a “snake oil salesman … praying on the gullible and vulnerable.” Although Ernst was exonerated after a 13-month investigation, he was forced into early retirement.

Simon Singh obtained a PhD in particle physics from Emmanuel College, Cambridge University, and the European Organization for Nuclear Research (CERN) in Geneva, before becoming a science writer. In addition to
Trick or Treatment
, Singh has written books about Fermat's Last Theorem, cryptography, and the Big Bang. On April 19, 2008, Singh wrote an article in
The Guardian
titled “Beware the Spinal Trap.” “The British Chiropractic Association [BCA] claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged
crying even though there is not a jot of evidence,” he wrote. “This organization is the respectable face of the chiropractic profession and yet it happily promotes bogus treatments.” In response, the BCA sued Singh for libel. Singh's case became a cause célèbre for those interested in reforming England's libel laws. On April 15, 2010, the BCA dropped its lawsuit; but not before Singh had lost two years of earnings and spent £200,000 in his defense. The lawsuit created an unanticipated backlash. Within months, one in four chiropractors in England were under investigation for making misleading claims.

T
he third way in which alternative healers cross the line is by draining patients' bank accounts, probably best evidenced by Stanislaw Burzynski's willingness to charge the parents of Billie Bainbridge £200,000 for the false hope of antineoplastons.