The most frustrating thing about alternative medicine, is that there is, in reality, no such thing. If alternative medicine is beneficial, then it’s m...more The most frustrating thing about alternative medicine, is that there is, in reality, no such thing. If alternative medicine is beneficial, then it’s medicine, and there’s nothing alternative about it. The alternative in alternative medicine refers to it being an exclusive, proudly divergent industry from conventional medicine with its clinical trials, replicable studies, and recalls of harmful or ineffective drugs; and make no mistake, it is a massive and lucrative industry. To top it off, the completely unregulated market means that not only can its proponents and sellers make any wild claim about a particular treatment’s efficacy (often times they are magical cure-alls), but they can also charge virtually whatever they want. After all, how can you put a price tag on your health? You get what you pay for, right?
Paul Offit became the arch-villain and poster-boy for evil Big Pharma in Jenny McCarthy’s misguided campaign to stop children from being vaccinated. I happen to think he is fighting an important fight. He is a pediatrician and he devoted twenty five years to co-developing the rotavirus vaccine, RotaTeq. I’m sure many have seen the map displaying the resurgence of several preventable diseases due to vaccine fear and denialism over the past few years. This has in large part been due to a discredited medical researcher named Andrew Wakefield, who conducted doomed studies (with conflicts of interest up the ass) asserting that the MMR vaccine caused autism. Hardly an unknown story, so I won’t get into it here. Offit has written books, articles and has appeared in documentaries to push back against this anti-progress and ultimate irresponsibility.
Anything that is claimed to be a cure-all is probably a cure-nothing. Worse, it is probably a prevent-nothing, alleviate-nothing, but it is not always a harm-nothing. Even Offit, who has been studying medicine for decades, has had it recommended to him that he abandon his experience and, as the mantra often goes in alt-med circles, ‘take control of your health’. Of course there are debates going on within medical science as to the best, most effective, safest treatments for patients, as with any field of science (punctuated equilibrium, string theory, anyone?), but the naturopaths, homeopaths, acupuncturists and, often times, chiropractors, have somehow discovered that their treatments render all other drugs and therapies and treatments for various diseases irrelevant. It’s strange how practitioners (I use the title loosely) of these alternative methods rarely disparage each other’s methods (certainly not to the degree of conventional methods). Perhaps this is because the Achilles heel for one of them is the Achilles heel for all of them; namely, lack of evidence.
It’s very difficult to untangle the mess of products available on the market, their praise-singers (some of them real doctors), and how seriously to take them. Our world is replete with afflictions and ailments and pestilences that have forced every human being ever born to watch someone they love degenerate, writhe in pain, or die horribly. I think it could be inherent in us to flock to whatever promises an end to the suffering we will all one day endure. Denial of death is a common theme in all major religions (even tech-and-science ones like Kurzweil’s Singularity sect). Is it any wonder that anti-aging gurus and natural, side-effect free dogmas have such devoted followings? Offit takes much-deserved shots at the media darlings responsible for pumping this stuff through its many circuits. Not surprisingly, Oprah Winfrey was kind of the seed that sprouted the middle-America movement through daytime television (or perhaps, more appropriately, the virus that infected its viewers). Through Oprah, we got Dr. Oz, and through Dr. Oz, we got Deepak Chopra and Andrew Weil; the trifecta of new-age healing, humors balancing, and energy restoration. Not that these people weren’t around prior to Oprah’s touting, but that on such a platform they became mainstream and highly trusted because, hey, they’re on TV!
Offit incorporates a concise history of medicine and uses it to convey why ancient remedies are not remedies at all. Science is a progressive endeavor, always rectifying itself to be most effectively applied, and rejecting past attempts which were borne of ignorance. My favorite example of this, which Offit explains perfectly, is acupuncture:
“Chinese physicians believed that energy flowed through a series of twelve meridians that ran in longitudinal arcs from head to toe, choosing the number twelve because there are twelve great rivers in China. To release vital energy, which they called chi, and restore normal balance between competing energies, which they called yin and yang, needles were placed under the skin along these meridian lines. The number of acupuncture points—about 260—was determined by the number of days in the year. Depending on the practitioner, needles were inserted up to four inches deep and left in place from a few seconds to a few hours.”
This exposes the arbitrary nature of ancient wisdoms. Just because something is old and has somehow endured, does not make it useful. This practice was implemented two hundred years before that Jesus fellow was allegedly born, when we didn’t know germs from demons, and the concept (or discovery) of the nervous system was centuries out.
There is quite a controversy stirring in the vitamin industry. I can hardly begin to sift through this mess. On the one hand, we know vitamins are essential. We also know that most of these vitamins are not produced by the body, so we have to ingest them, thus the Recommended Daily Allowance. Studies have been being conducted in recent years and they are controversial to a degree. Some experts have expressed their doubts as to the legitimacy of certain studies, though I haven’t been able to find which specific studies (all of them?). In more than one study, vitamin supplementation had been ostensibly linked to higher cancer risk and death. Linus Pauling, the nobel-prize-winning chemist and peace activist, was the grandfather of the vitamin craze, as Offit explains, “What few people realize…is that their fascination with vitamins can be traced back to one man…” He’s the reason Vitamin C is supreme in public consciousness. He recommended taking 3,000 milligrams of the stuff per day and that it could cure the common cold (inevitably, this gave way to even crazier claims of its curative powers), and here’s where I get really confused. On a recent episode of Joe Rogan’s podcast, The Joe Rogan Experience, one Dr. Rhonda Patrick bemoaned findings (again, which specific findings, I am not at all sure) that vitamin C, taken orally, was not effective in combating or preventing any illness. Dr. Patrick’s contention was that Pauling had taken his dosages intravenously and so the orally supplemented studies were moot. But, if that’s the case, why was Pauling recommending supplementation, and so much of it? A far as I can tell, Pauling never specified that it should be taken intravenously, and what’s more, that would be impractical for your average patient to inject themselves, or to hook up to an I.V. every day for vitamin intake. And why are ingestible vitamin C tablets and pills the only things readily available, if intravenous is the way to go? I know I’m missing something, and I’m no expert, but until evidence tips the scale in the other direction, I’ll eat oranges instead of supplementing. Apologists for Pauling ostensibly like to ask “do you have a Nobel Prize?”, to which I would respond, no, and neither does Pauling…in medicine.
The FDA is not perfect, and they have been pressured to and have allowed drugs to pass through the approval-stage without enough diligence, but here’s the thing; they are held accountable for mistakes and perfunctory approvals. The FDA issues recalls, pharmaceutical companies must face the consequences; the supplement industry has no such regulation in the first place and so never has to answer for its useless or potentially dangerous products. It has successfully merged leftist-anti-corporate animus with libertarian free-market-anti-government-intervention values. The market has spoken, and supplements are big business. Of course, its customers don’t like acknowledging this. No, these are the more natural products that big bad pharma doesn’t want you to know about! Gerry Kessler, founder of the supplement company Nature’s Plus “must have known that he couldn’t defeat the FDA by proving his product’s claims. His best chance was to persuade the American public that what the FDA really wanted was to limit their freedom.” Sound familier? Proponents of deregulation don’t care to rely on evidence, as it is often inconvenient for them. What they invoke is the freedom to sell snake oil, or tainted meat, or to pollute, or poison water, or eschew worker safety because it is their inalienable right to do so and these are acceptable prices to pay for their profits. (Yes, I am comparing the supplement industry to the oil, gas, and meatpacking industries [I invoke Upton Sinclair’s name far too often, but even Offit does in this chapter]). The market itself will not sort this stuff out, despite libertarian dogma, and I’m not suggesting government is the sole, or even the best, overseer of these practices, but the FDA was implemented for a noble, and inarguably necessary, reason, and it’s as good as whoever is conducting it at any given time, the government as a whole be damned.
“Although mainstream medicine hasn’t found a way to treat dementia or enhance memory, practitioners of alternative medicine claim that they have: ginkgo biloba.” This sentence resonates across so many fields, I could hardly contain myself as I read it. Neil degrasse Tyson has famously dubbed Intelligent Design a ‘philosophy of ignorance’, meaning, not that anyone advocating such a position is ignorant, but that the theory itself is based entirely on what we do not yet know. Alternative health claims are perfect corollaries to this philosophy of ignorance and sync up in parallel with the attitude of religious apologetics when it comes to morality, consciousness, the origins of life on earth and the cosmos as a whole. I like to call it the ‘you don’t have the answers, therefore we do’ argument.
Cranks and quacks are everywhere, sometimes they’re charlatans and hucksters, sometimes they’re well-meaning hopefuls, and sometimes they’re conspiracy nutcases who see the lack of forthcoming evidence in their favor as a personal affront and deliberate orchestration to hide the truth. All types can and have gained traction in the medical and health sphere. Wakefield, Oz, Pauling, Blumenthal, Burzynski are only a few of the more well-known proponents of unproven, or disproven treatments, causes, and preventions.
Magnanimously and justifiably, Offit ends with positive words on behalf of the placebo response (not effect, because it’s not a given treatment itself that does it, but the body’s [brain’s] response). The placebo response is spectacular. The brain can essentially be tricked into thinking it feels better. If someone feels something working, whether it’s homeopathy or a sugar pill, it’s that person’s mind creating a response to an interchangeable and expendable treatment. This has been remarkably useful for things like joint and muscle pain. The only problem is, it’s not an actual cure. It provides temporary relief, and that’s when, even if it helps you feel better and lifts your spirits, homeopathy (or any bogus treatment) becomes dangerous. Placebos, powerful though they may be, cannot cure cancer, diabetes, AIDS, or anything else. Being aware of its limitations is important, lest someone desist from their chemotherapy, insulin, dialysis, antiretroviral drugs in favor of coffee enemas, herbs, spices, and therapeutic touch. However responsive one may be to a placebo, there is no evidence to suggest it shrinks tumors or wards off terminal illness.
I think Offit’s thesis with this project is that we should not give alternative medicine a free pass “because we’re fed up with conventional medicine”. It’s saddening and maddening to live in a world that has no qualms with infecting us with horrible diseases and maladies, and doesn’t even have the courtesy to lay out obvious treatments for us. When it comes down to it, everything is natural, and natural does not equal good, or safe. This capriciousness in nature has paved the way for fearful people, parents in particular, to veritably lose their minds in their pursuit to keep themselves and their children safe and healthy.
I will take my leave with these fine words from the prologue to this book:
”I learned that all therapies should be held to the same high standard of proof; otherwise we’ll continue to be hoodwinked by healers who ask us to believe in them rather than in the science that fails to support their claims. And it’ll happen when we’re most vulnerable, most willing to spend whatever it takes for the promise of a cure.”