the
Skeptic's Dictionary Newsletter
44
July 24, 2004
"Some cause happiness wherever they go;
others, whenever they go." -- Oscar Wilde
In this issue: Some rest for the wicked;
Skepticism in Ireland; Amazing Meeting 3;
The Skeptic's Dictionary goes digital;
Prince Charles and Gerson Therapy;
Quantum Touch quackery;
Scientologists invade Botswana;
the dangers of passive smoke;
my paper on Pranks, Frauds, and Hoaxes published in Skeptical Inquirer;
it's not too late to sign up for the Skeptic's Toolbox
(August 12-15); and a thank you.
Changes in The Skeptic's Dictionary and Skeptic's Refuge
I have made no significant changes in either website since the last
newsletter. I took a three-week break from all writing while traveling in
Ireland. Before that I was revising most of the chapters in Becoming a
Critical Thinker. (If my printer can handle it, a "beta" version will be
available for purchase soon.) I was also working on a talk related to my new course on
Critical Thinking about the Paranormal and the Occult, which I delivered in
Sacramento, California, and Dublin, Ireland, last month.
Irish Skeptics
I'm happy to report that skepticism is alive and well in Ireland.
The Irish Skeptics Society,
led by Paul O' Donoghue and Mike Reen, began soliciting members last
October. The group now numbers about 150. More than 80 people showed up for
my talk in Dublin. I was told that this was a good turnout since a very
important soccer match was being televised during the talk. They needn't
have worried. As it turned out, I finished just in time for everyone to
adjourn to the bar and watch the final few minutes of the match. (Sorry, I
can't remember who was playing, much less who won, but I assure you it was
very important to most Europeans!)
Paul arranged with
Hodges Figgis,
a wonderful bookstore on Dawson St., to put my
book on display (along with some
heavy hitters like Carl Sagan and
James Joyce!).
Mark your calendar if you will be in Dublin next October 6th.
James Randi will be addressing the Irish
Skeptics at that time.
AM3
Speaking of Randi...Richard Dawkins headlines the
Amazing Meeting 3 to be held in Las Vegas, January 13th to 16th, 2005,
at the Stardust Resort and Casino on The Strip. I've been to the first two
Amazing Meetings and can attest to their value: great speakers, great
entertainment, great people. You won't be disappointed....except, of course,
when you have to listen to Hal Bidlack read poems or rag on Phil Plait.
Digital Skeptic's Dictionary
The Skeptic's Dictionary is now available as an e-book for your
PalmOS devices. The price is $19.95 from
Amazon.com.
Prince Charles and "Alternative" Medicine
While I was in Ireland, the Prince of Wales--a
longtime advocate of "alternative" medicine--caused quite a stir with an
anecdote he told in a
speech to some 200 healthcare professionals. Prince Charles is the
president of the (now
defunct) Foundation for
Integrated Health, an outfit devoted to promoting the use of therapies
considered quackery by
many skeptics..
"'I know of one patient who turned to Gerson Therapy,"
said the Prince, "having
been told she was suffering from terminal cancer and would not survive
another course of chemotherapy. Happily, seven years later, she is alive and
well. So it is vital that, rather than dismissing such experiences, we
should further investigate the beneficial nature of these treatments."
Gerson Therapy was developed by Dr. Max Gerson (1881-1959) and is based
on the belief that "toxins" cause diseases such as diabetes and cancer and
that these "toxins" can be eliminated from the body by a diet rich in
fruits, vegetables, and coffee enemas. He believed that "cancer was a
symptom of a diseased, polluted body in which tumors form when the liver,
pancreas and other organs are out of balance, and reasoned that animal and
dairy products and other chemicals must be banned. The coffee enemas are
used to strip the gut of harmful bacteria and pollutants, but specialists
argue they often lead to other problems such as dehydration."*
Most scientists today agree that eating fruits and vegetables is good for
you. Few recommend the large quantities of juices used in Gerson Therapy.
Enemas
have been used in body purification and cleansing rites for thousands of
years by many cultures. "The coffee enema appeared at least as early as 1917
and was found in the prestigious Merck Manual until 1972. In the 1920s
German scientists found that a caffeine solution could open the bile ducts
and stimulate the production of bile in the liver of experimental animals. "*
Gerson believed that caffeine would act as a detoxifier by stimulating the
liver. He first used coffee enemas to treat tuberculosis, a bacterial
infection. In the 1930s he began treating cancer patients with coffee
enemas.
The conventional view of cancer does not find any evidence for the view
that removing "toxins" is effective for treating cancer. Those who say that
Gerson Therapy is scientific tend to focus on such evidence as "substances
found in coffee—kahweol and cafestol palmitate—promote the activity of a key
enzyme system, glutathione S-transferase, above the norm." They note the
evidence, accepted by the medical establishment, that certain substances in
fruits and vegetables can neutralize free radicals. However, the notion is
unsubstantiated that once cancer has been established, detoxification by
diet and enemas is effective in fighting the disease. Whatever benefit
Gerson Therapy might have for preventing disease does not translate into
effective treatment for those who have cancer. This point is lost on Prince
Charles and his supporters, however.
For a skeptic, which Charles is not, several questions regarding his
anecdote should be asked: Who is
this phantom person that was saved by juices and enemas? and what evidence is there that she really was suffering
from terminal cancer? Who told her she would not survive chemotherapy? And,
what evidence is there that Gerson Therapy had anything to do with her being
alive and well seven years after her alleged bout with "terminal" cancer?
Of course, it would be rude to ask the Prince for such details. His point, in any case, is
probably not that cancer patients should give up
chemotherapy and turn to Gerson Therapy. (A spokesman for Prince Charles
said that the Prince had never suggested people should abandon their
orthodox treatments for alternatives – rather that alternatives can be
useful.*) Even if that were his point, there
is little likelihood that there would be a mass exodus from
scientifically-based clinics to an outpost in Tijuana (The Baja Nutri Care
Clinic). (The treatment is illegal in the U.S.) The cost--about
$15,000 for three weeks of treatment--is prohibitive for most folks.
Yet, dying people can be desperate and an anecdote from Prince Charles might
provide just the shred of hope they need to take the risk.
His point, however, may have been that treatments with satisfied
customers, no matter how ridiculous, useless, or unlikely to prove effective
should be subjected to scientific trials. This notion is apparently
attractive to many people, yet it is not very logical and there are good
reasons why scientists--real scientists--don't use the satisfied customer
criteria as a guide to what should be subjected to a clinical trial. It is
important to know why the customers are satisfied. Are they satisfied
because they have objective, unbiased evidence that the therapy is
effective? Good. Then it may be worth testing. Are they satisfied because
they feel better or because they think the therapy cured them
of a deadly disease? Sorry, such subjective evidence isn't sufficient to
warrant an investigation. Steve McQueen said he felt much better after his
Laetrile treatments right before he died. Many people think they've been
cured of deadly diseases when they didn't have a deadly disease in the first
place.
I first heard of Gerson Therapy when a local TV newswoman, Pat Davis,
announced that she had breast cancer and was not going to submit to
chemotherapy, opting instead for Gerson Therapy. In my entry on alternative
health practices, I write
Pat Davis followed a rigorous 13-hour-a-day regimen of diet (green
vegetables and green juices), exercise, and coffee enemas (four a day)
developed by Dr. Max Gerson. Davis’ mother had had breast cancer twice,
undergoing chemotherapy and a mastectomy. Davis knew the dangers of
chemotherapy and the effects of breast surgery. She refused to accept that
there were no alternatives. Gerson therapy gave her hope. When it was clear
that the Gerson treatment was ineffective, Davis agreed to undergo
chemotherapy. She died four months later on March 20, 1999, at the age of
39, after two and one half years of fighting her cancer. Could chemotherapy
have saved her had she sought the treatment earlier? Maybe. The odds may
have been against her, but the slim hope offered by scientific medicine was
at least a real hope. The hope offered by Gerson is a false hope through and
through.
Davis's mother is still alive. I tell this anecdote not to prove that
Gerson therapy doesn't work but to remind those who, like the Prince, know
of someone or of someone who knows of someone who survived a death sentence
by using vitamin C or Laetrile or bile of ogre, that there are untold
anecdotes that nobody tells because the patients are dead. Dead men, women,
and children don't
tell anecdotes.
Who was Max Gerson and why would anyone follow his advice of massive
quantities of vegetable juice and daily coffee enemas? According to
Croft
Woodruff, "Max Gerson was the personal physician and friend of Albert
Einstein and the philanthropist and missionary, Albert Schweitzer...Albert
Schatz was also a friend of Dr. Gerson, Dr. Einstein, and the Schweitzers."
(Many consider Schatz to be the true discoverer of streptomycin.)*
Schweitzer believed that Gerson's diet therapy cured him of adult onset
diabetes and cured his wife of TB. Schweitzer said of Gerson
...I see in him one of the most eminent geniuses in the history of
medicine. Many of his basic ideas have been adopted without having his name
connected with them. Yet, he has achieved more than seemed possible under
adverse conditions. He leaves a legacy which commands attention and which
will assure him his due place. Those whom he has cured will now attest to
the truth of his ideas.
What Gerson did was try to cure himself of "migraines" by diet.*
Apparently, his migraines went away after he went on his strict diet. He
concluded that the diet cured him of the migraines. Gerson and others seem to have
reasoned similarly when various ailments or symptoms, including cancer, were
apparently removed or alleviated after going on the diet. As far as I can tell, Gerson
never used a control group and thus was never justified in concluding that
the effects he observed were due to the diet. He also did not report on the
failures, only the apparent successes. There are no Pat Davises in the
literature, but there are many in the graveyard. In short, not only is there no scientific basis for Gerson Therapy, there is little or no reason for
doing clinical trials, as suggested by Prince Charles.
Prince Charles's speech inspired Dr. Michael Baum to respond with a
scathing letter published in the online version of the
British Medical Journal. "I have much time for complementary therapy
that offers improvements in quality of life or spiritual solace, providing
that it is truly integrated with modern medicine, but I have no time at all
for alternative therapy that places itself above the laws of evidence and
practices in a metaphysical domain that harks back to the dark days of
Galen," wrote Dr. Baum.
Baum's letter and the
dozens
of responses it elicited are well worth reading. On one side is the
notion that Prince Charles's longstanding position of advocating alternative
medicine qualifies him as a dunce who might well read the entrails of birds
for guidance. On the other side are the scientists with their evidence-based
medicine, who follow reason and rationality, logic and empirical evidence.
Then there are the anecdotes. Some tell of how conventional medicine saved
lives; some tell of how alternative medicine saved lives. This raises the
question: why do we give more weight to some anecdotes and dismiss others?
If we are already convinced of the uselessness of alternative remedies, we
might not question the efficacy of a conventional treatment, while we
readily dismiss the efficacy of an alternative therapy. We also tend to
ignore the cases of those who underwent the conventional treatment but died.
Why? Conventional medicine has a better track record and the
probabilities are on its side.
Many of the letters remind us of the fallibility of conventional
medicine. Because of the great advances in medicine, we have come to expect
miracles as the standard. One area where the miracles are glaringly small in
comparison to, say, the treatment of infectious diseases, is in the area of
cancer treatment. This may be why so much quackery focuses on bogus
treatments for cancer.
There is also the untidy fact that conventional medicine sometimes kills
by various kinds of malpractice. While nobody will ever die because a
classical homeopath prescribed the wrong medication. But these issues, much
on the minds of some of the respondents, are irrelevant to whether therapies
like Gerson Therapy should be administered much less put to the test.
Several of the letter writers claim either to have successfully treated
cancer with food or to have successfully treated themselves with food.
As far as I know, there is good evidence that diet plays a role in the
prevention of cancer (and other diseases) but there is no strong evidence
that diet can reverse cancer. It should be obvious that just because a
cancer goes into remission after one goes on a special diet, it does not
follow that the diet had anything to do with the remission.
I think one letter writer captured the feeling of many of the defenders
of Prince Charles when he wrote:
As one who has cured himself of cancer using holistic methods, without
going to a doctor, I know whereof I speak. Conventional medicine has
nothing to offer for cancer except surgery, radiation, and
chemotherapy--otherwise known as slash, burn, and poison--and more and
more people are catching on that the mutilation, burning, and toxic
chemicals are completely unnecessary.
Modern medicine, in thrall to the pharmaceutical industry, fails
utterly to understand that cancer itself arises from toxicity and that a
cure depends on righting the body's internal energy balance. Gerson's diet
works well, and so do many other techniques. The fact that large numbers
of people are trying them and succeeding is a reproach to medicine's many
failures. The holistic way typically offers superior results with fewer or
no side effects and much lower cost--not to mention that patients aren't
sent through an assembly line and get a practitioner who actually has the
time to listen and respond.
I wonder if this fellow also diagnosed himself with cancer. In any case,
New Age beliefs abound: that "energy" balance, harmony, and the like are
relevant to disease; that one can take control of one's health and disease
by manipulating "energy" through diet, exercise, and happy thoughts; that
"toxins" are the cause of illness and can be removed by diet and enemas; and
that doctor's are unnecessary or even dangerous. This may
be a very distorted and erroneous view of both conventional medicine and the
nature of disease, but it is widespread and warrants concern. Far from
seeing Prince Charles as a dunce, some people see him as a knight in shining
armor. This is worrisome, although some cynical skeptics welcome such
leadership and see it as natural selection at work and believe it will
eventually lead to a healthier species.
One of the more interesting letters in response to Baum's criticism of
Prince Charles is from Hilary Butler, self-described
as a freelance journalist, who calls into question the standard P-values
used in clinical trials for significance. Butler writes
Could it be that this standard "scientific" baseline is a load of
hogwash decided by an arbitrary standard chosen from the crystal ball
from the er.. um... well... "I don't know" domain?
Could it be that the results of any research using this arbitrary
standard is thereby subject to critical flaws?
Flaws which have been written about in great detail in the 80's by
Professor
James Berger of Purdue University, who published an entire series of
papers alerting researchers to the tendency of the standard tests to be
very wrong.
Oh and Professor Leonard
Savage, who said that P-values were able to boost the apparent
significant of implausible results by a factor of 10 or more.
Both warned that P-values were very prone to attribute significance to
fluke results.
Both were ignored. But then, such is the way of medical history.
Butler seems to suggest that there is no point in testing Gerson Therapy
because the methods used to evaluate the data of double-blind, controlled
experiments have been misused.
All this and more from one little anecdote, indicating what? A skeptic's
work is never done.
Why do we bother? Let me relate an anecdote.
A young woman who has been a "fan" of the Skeptic's Dictionary for
several years wrote me:
I never thought that I would have to be looking up the Skeptic's
Dictionary for anything but fun and interest.
But my father has just been diagnosed with terminal cancer (pancreas
and liver) and has less than 6 months to live. He is now vulnerable prey
to the snake oil salesmen.
Two weeks after diagnosis (inoperable/no western treatment possible) he
is already on the Chinese herbalist quack medicine. For a couple of
hundred dollars he has some capsules and a foul liquid. My attempts to
find out what is in the formula have been thwarted, as the writing on the
box is in Chinese characters. No chance of deciphering. A book accompanied
these medications and if what is in the book is what is in the
capsules/liquid (Tiang Xiang remedy no. 1, 2, 3 and 6) then it includes
such wonderful ingredients as essence of pearl, essence of poisonous toad
(doesn't specify which species), ginseng, natural indigo, essence of male
animal bile, etc.
So what? you might ask. The stuff can't do him any harm, can it? Yes, it
can.
* It causes dad PAIN when he takes it.
* He has to take it 3 times a day. He cannot eat for an hour before or
after. He has to schedule his pain-relief medication around it. In short,
it is ruling his life. He cannot enjoy himself because whether he goes to
a restaurant or to the beach or to the races is dictated by his Chinese
herbal medicine times. He forgot to take his "medicine" with him the other
day and we had to race home from the museum in stress.
* It could be causing dad PHYSICAL DAMAGE as his liver isn't working
properly, it cannot strain out the toxins in this "medication".
In short, the HARM herbal medicine can do in a terminal case where
Western medicine can not help is this:
* increase stress
* increase discomfort
* shorten the already pitifully short amount of time left
* waste money
* raise false hopes that will inevitably be dashed.
Worse, as soon as this medication is disproved, a well-meaning uncle
has another 10 different herbal remedies lined up for Dad to try.
No doubt the uncle is well-meaning. It seems to be a natural instinct in
some people to rush to the aid of someone in distress and offer "cures" and
"remedies" they know nothing about in the misguided belief that hope can
cure all. In some families where everyone is a New Ager or postmodernist,
this may not be much of a problem. But, if there is just one skeptical,
logical, empirically minded family member who objects to making a dying
person's last days, weeks, or months more miserable or full of false hope,
or who objects to wasting money and precious time on useless remedies, then
there will be increased stress among family and loved ones.
The young woman recently sent me an update:
Dad's bloodtest did in fact show that he was still declining despite
that Tiang Xiang mixture, and thankfully he has given it away.
He is now on proper pain-relief medication from a palliative care
doctor and is enjoying a much better quality of life than previously.
I am driving home to look after Dad now, after being in another city
and I intend to make his last days as full of fun and love as possible.
I'm sure that the Prince and many of the defenders of alternative cancer
treatments think they are contributing to the well-being of people. Not all
are unscrupulous crooks taking advantage of desperate people. But, as Fr.
Becker told me many years ago, the road to Hell is paved with good
intentions.
I'll conclude by noting that in his speech the Prince of Wales defended
alternative therapies because they offer care and hope, making the patient
feel better. The implication is that conventional medical doctors are
uncaring stiffs who are indifferent to their patients' fate. While it is
certainly true that there are uncaring stiffs in most professions, it is not
true that most medical doctors are unfeeling robots. The Prince also claimed
"it has been demonstrated that in a variety of cancers, such as breast
cancer, that attitude of mind can not only raise the quality of life but in
some cases can even prolong life." I don't know what study the Prince had in
mind but a
1989 study led by Dr. Pamela J. Goodwin of the University of Toronto and
published in the New England Journal of Medicine found that attitude
can make patients feel better but it doesn't help them live longer.
further reading
-
Questionable Cancer Therapies by Stephen Barrett, M.D. Victor Herbert,
M.D., J.D.
-
"Why
Bogus Therapies Often Seem to Work" by Barry L. Beyerstein, Ph.D.
-
The
Scientific Review of Alternative Medicine and Aberrant Medical Practices
-
Now Charles backs coffee cure for cancer
-
Dr. Max by Giuliano Dego
by Ralph Moss (Skeptics will especially like the part about Gerson's
son-in-law and EVP. Dego
claims Gerson spoke to him from the dead via radio and told him that he
didn't die of pneumonia (as his death certificate stated) but that he was
poisoned with arsenic. Gerson's widow is said to have verified the claim
that high levels of arsenic were found in Gerson's body and that he was in
perfect health when he died. Hmmm. Arsenic-laced coffee?)
-
The Gerson Institute
-
Skeptic's Dictionary entries on
communal reinforcement,
confirmation bias,
control study,
Occam's razor,
the placebo effect,
the post hoc fallacy,
the regressive fallacy,
selective thinking,
self-deception,
subjective validation,
testimonials, and
wishful thinking.
Quantum Touch
Longtime reader Tom Kite writes:
Interesting that you should mention Richard Gordon in the latest
newsletter. About three years ago I went to a talk he gave at a local
new-age shop near Portland, OR. I went expecting to be the only skeptic
in the audience, and I was right. If I hadn't been there, his
pronouncements would have gone completely unchallenged. As it was, I
asked as many questions as possible (without being rude) and incurred
the wrath of most of the other audience members. I have to say, however,
that Richard was quite willing to listen to me and was more than civil.
I got the impression that he is just utterly deluded, rather than a
charlatan - but then of course not bothering to listen to skeptics or
conduct research could be seen as a form of charlatanism.
The best part of the evening (apart from the bit where a particularly
kooky audience member was yelling at me that cold fusion was real, too)
was when Richard asserted that he could 'change the molecular structure
of water' by placing a glass of water between his hands. Obviously I
could not let this fantastic claim go by unchecked, so I asked him how
he knew the structure had been changed, and suggested that he use a mass
spectrometer or some other device to determine it. Well, he said, there
was only one machine sensitive enough to measure the change, and it was
at Stanford. I naively suggested that he go down there and do the
experiment, but was told that it would cost $500. I offered that it was
a small price to pay to overturn the whole of physics, but apparently
even quacks have their financial limits, even while they are selling
tablesful of their book at $18.95 a pop.
A few days later I wrote Richard an e-mail pointing out that his
method of healing was no more outlandish than modalities which were
receiving huge amounts of money in grants from NCCAM (Elisabeth Targ's
healing on the phone had that year received a great wad of cash from
them), and that he should apply. He wrote back promptly, thanking me for
the suggestion. He'd never heard of NCCAM.
As far as I can tell from looking at the website, nothing much has
changed over the years. Somehow I doubt the experiment at Stanford ever
got done, and I imagine the breakthrough paper in JAMA won't be
appearing anytime soon.
Tom, I think you can take that to the bank.
Scientologists in Botswana
Richard Harriman writes that
the Scientologists have arrived in Botswana, my adopted home,
under the name of the "African Pioneer Movement". As can be seen from this
article: the buggers are here, adopting the usual "we're here to
help you solve all you psychological problems" approach.
Botswana is a fertile ground for them, having fallen victim to every
funny little schismatic church that's turned up here over the last few
years. However, I want to do my very best to warn my local friends about the
perils of Hubbard's lunacy. I'm going to be writing to the press, contacting
radio stations, and generally spreading the word.
Your site is one of the very best logical critiques of them and their
weird little ways. I'd like your permission to quote you liberally.
Quote away, Richard. And good luck in battling the alien Hubbardian
forces.
Passive smoke
While the study linking passive smoke to 3,000 lung cancer deaths a year
may be flawed, (I NO LONGER THINK THIS STUDY IS
FLAWED: see
Newsletter 41) other studies continue to support a causal connection between
passive smoke and disease. For example,
researchers report in the online edition of the
British Medical Journal that exposure to secondhand smoke may increase
the risk of coronary heart disease by 50 percent to 60 percent.
Pranks, Frauds, and Hoaxes
Look for my article "Pranks, Frauds, and Hoaxes from around the World" in
the latest issue of Skeptical
Inquirer (vol. 28, No. 4 - July/August 2004).
Skeptic's Toolbox (August 12-15)
I hope to see some of you in Oregon next month at the CSICOP-sponsored
Skeptic's Toolbox.
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