Killing Us Softly: The Sense and Nonsense of Alternative Medicine. Dr Offit Paul

promotes the relatively modern concepts of homeopathy and chiropractic manipulations, both of which represent a kind of devolution in medical thinking.

      Homeopathy was the creation of Samuel Hahnemann, who practiced in Germany and France between 1779 and 1843. Hahnemann was disturbed by the brutality of nineteenth-century medicine, which included bloodletting with leeches, poison-induced vomiting, and skin blistering with acids. He wanted a safer, better way to treat people. His epiphany came in 1790. While ingesting powder from the bark of a cinchona tree, Hahnemann developed a fever. At the time, it was known that cinchona bark, which contained quinine, could treat malaria. Hahnemann believed that because he had fever, and because fever was a symptom of malaria, medicines should induce the same symptoms as the disease. For example, vomiting illnesses should be treated with medicines that cause vomiting. (Homeopathy literally means “similar suffering.”) To be on the safe side, Hahnemann also believed that homeopathic medicines should be diluted to the point that they aren’t there anymore. Although the active ingredient was gone, Hahnemann believed, the final preparation would be influenced by the medicines having once been there.

      Like homeopathy, chiropractic manipulations are also the brainchild of one man: Daniel D. Palmer. Palmer was a mesmerist who used magnets to treat his patients. But in 1895, when a man who had been deaf for seventeen years walked into his office, Palmer tried something else. Believing that deafness was caused by a misaligned spinal column, which he called “subluxation,” Palmer pushed down on the back of the man’s neck, hoping to realign his spine. It worked; the man recovered his hearing immediately. (The event is often referred to as “the crack heard round the world.”) Most miraculous about Palmer’s cure is that the eighth cranial nerve, which conducts nerve impulses from the ear to the brain, doesn’t travel through the neck. Palmer then took the next illogical step, arguing that all diseases were caused by misaligned spines. Because this isn’t true, it shouldn’t be surprising that studies have shown that chiropractic manipulations don’t treat many of the diseases they are claimed to, such as headaches, menstrual pain, colic, asthma, and allergies.

      Although Oz promotes therapies born before scientists had determined what caused diseases and why, he’s enormously popular—for many reasons.

      First, Oz and his Superstars provide an instruction book for something that doesn’t come with instructions: life. Collectively, books written by Oz, Weil, and Chopra tell people exactly what to eat and when to eat it; how to be a friend; how to sustain a loving relationship; how and when to exercise; which shampoos, cleaning fluids, laundry detergents, and baby foods to use; how to prepare meals (including “Dr. Weil’s Favorite Low-Fat Salad Dressing”); and how to treat almost every possible illness. It’s reassuring to know that there’s a right and wrong way to do everything. And because these books are so definitive, so clear about how to handle almost any disease, they inspire a cultlike devotion among their followers. Do it our way and you’ll live longer, love better, and raise happier, healthier children. Given life’s arbitrary, capricious, and unpredictable nature, these books can be quite comforting.

      Another lure of alternative medicine is that it’s personalized. Practitioners of modern medicine can appear callous and insensitive. Patients feel more like a number than a person. That’s where alternative healers come in: they provide individual care, because they care. “Doctors are trapped in this system,” says Andrew Weil. “A ravenously for-profit system.” But Weil isn’t trapped: “I listen to them,” he says. “I take sixty minutes on a first visit.” “My advice for everybody,” says Mehmet Oz, “is to customize therapy for yourself.”

      The promise of ancient wisdom is also appealing. When Mehmet Oz discussed acupuncture on The Dr. Oz Show, he made a rather surprising statement. “It’s the basis of ancient Chinese medicine,” he insisted. Oz was arguing that we should trust ancient medicine because it’s ancient. Today’s culture is filled with this sentiment. For example, in the movie 2012, starring John Cusack and Amanda Peet, the world is coming to an end—something that apparently had been predicted by the Mayan calendar. “All our scientific advances,” laments one scientist, “all our fancy machines—the Mayans saw this coming thousands of years ago.” The writers of 2012 knew their audience. Many people believe that ancient healers and soothsayers, free from confusing modern technologies, possessed a clearer, wiser view of things. “One of the arguments mobilized by alternative medicine practitioners against orthodox medicine is that the latter is constantly changing while alternative medicine has remained unaltered for hundreds, even thousands of years,” wrote Raymond Tallis in Hippocratic Oaths: Medicine and Its Discontents. “The lack of development in 5,000 years can be a good thing only if 5,000 years ago alternative practitioners already knew of entirely satisfactory treatments. If they did, they have been remarkably quiet about them.” Modern medicine is carved by centuries of learning. It continues to evolve because it continues to generate new information. It isn’t fixed in time. But the fluidity of modern medicine can be unsettling. Alternative medicine’s certainty, on the other hand, can be quite reassuring.

      Ironically, while alternative remedies are embraced in the developed world, they’re often rejected in the countries where they originated. In mainland China, for example, where both traditional and modern therapies are available, only 18 percent of the population relies on alternative medicines; in Hong Kong, 14 percent; and in Japan, even less. In China, acupuncture is embraced almost solely by the rural poor. “It’s easy for the well-fed metropolitan with time and money on his hands to talk about dealing with chronic symptoms with ayurvedic medicine or Chinese herbal therapies or ancient African or Native American remedies,” writes John Diamond in Snake Oil and Other Preoccupations. “But if you go to the countries where those remedies are all they have, you’ll find them crying out for good old Western antibiotics, painkillers, and all the rest of the modern and expensive pharmacopoeia. When the government of South Africa complains that not enough is being done to help the 10 percent of its population which is HIV-positive, it isn’t asking for help with preparing ‘natural’ remedies: it wants AZT.”

      Traditional healers also offer something else. Where modern medicine is spiritless and technological, they argue, alternative medicine is spiritual and meaningful. “The more the universe seems comprehensible,” wrote Steven Weinberg, a Nobel Prize–winning physicist, “the more it seems pointless.” Although modern science offers the prospect of longer lives, it doesn’t offer the prospect of more meaningful lives. Alternative medicine, on the other hand, offers something greater: better health imbued with a deeper sense of purpose. Oz, Weil, and Chopra proffer their remedies with a spirituality that borders on mysticism. “Nothing is more dangerous than science without poetry or technical progress without emotional content,” wrote Houston Stewart Chamberlain, a German philosopher. In a culture that doesn’t understand technology, and is often frightened and disappointed by it, spiritualism is an easy sell.

      Finally, practitioners of alternative medicine appeal to the popular notion that you can manage your own health, that you don’t need doctors to tell you what to do. “Alternative medicine is at the grass roots level,” says Oz. “And because of that, nobody owns it. Alternative medicine empowers us. And if it does work for you, don’t let anybody take it away.” The offer of control in a health-care system where patients feel little or no control is irresistible. “The lure of alternative therapies won’t end,” says Harriet Hall, a former flight surgeon and a regular contributor to Skeptical Inquirer magazine, “until you take the ‘human’ out of human nature.”

      At the heart of our distrust of modern medicine is the notion that we’ve rejected nature at our own peril—that big pharmaceutical companies, by synthesizing products in laboratories, have led us away from the natural products that allow us to live longer. And what could be more natural than vitamins.

Part II

       2

       The Vitamin Craze: Linus Pauling’s Ironic Legacy

      I