Ack! ChopraWoo!

Usually Deepak Chopra’s nonsensical writings at the Huffington post about mind-body healing are so vague and bland I don’t bother addressing them. The mind controls the body, the mind is powerful, blah blah blah, who cares right? Well, today Chopra pulled back the curtain and we see the crank within. It’s a reminder that behind the facade of all the touchy-feely nonsense of the alties is a campaign against science and legitimate medical practice. We start with the standard quack appeal to the individual, which sounds nice, but in practice basically means they have no consistent method to apply their nonsense.

The great promise of mind-body medicine will never be fulfilled as long as the treatments are unpredictable. This has been a major stumbling block in the West, ever since the original excitement over acupuncture in the Seventies and Ayurveda in the Eighties. Patients who have been helped sing the praises of alternative medicine while official clinical trials don’t satisfy the skeptics. In the East it is more easily accepted that each patient is unique, and therefore one cannot expect that the same therapy will lead to the same results in everybody.

You know, I simply don’t believe the alties when they tell us that they treat each patient differently. Whenever I see their writings they are always recommending specific treatments for specific diseases. Where is all this tailored treatment they talk about? And further, what is their method for determining which individuals need which treatment? Reading auras? They should just admit they’re full of it right here.

But then Chopra shows the real objective of altie medicine quacks – the undermining of evidence-based medicine and with standard denialist tactics no less.

In practice there is no such thing as complete reliability, however, and one must consider how many patients die on the operating table or suffer extreme side effects from drugs.

This is the classic altie attack on medical science. Our treatments work. They are efficacious. They have physiological effects on the body. Part of the problem with this is that also tends to make them dangerous as they have side-effects, and some drugs have a narrow therapeutic window. But the goal here is to suggest that we just throw drugs at people willy-nilly, with no concern for morbidity and mortality of our treatments. Contrary to the quack assertions though, Western medicine obsessively monitors the efficacy of treatments for net benefit. Whereas the selection pressure on altie meds selects for drugs that do nothing, the pressure on evidence-based medicine is to show continual and measurable improvements in people’s quantity and quality of life. The reason people routinely live well into their 80s these days isn’t because of widespread use of homeopathy. It’s because of the enormous success of evidence-based medicine and public health interventions.

Chopra’s next mistake? An idiotic generalization followed by a healthy-dose of fearmongering.

There is also the problem that drugs become less effective over time — the phenomenon known as tachyphylaxis — and that “super germs” develop in hospitals, causing a serious rise in illness and death caused by the treatment — a phenomenon known as iatrogenic disease.

Umm no. Some drugs show tachyphylaxis, but not all drugs, and doctors know about this. As a result we dose the drugs carefully – like with nitroglycerin – or titrate up doses to reach therapeutic levels. This guy is supposedly a MD and he doesn’t even understand the definition of this word and the relevant pharmacology. It’s actually pretty sad.

Multiple-resistant strains are a problem, there is no question about that, but one has to remember that most stays in a hospital aren’t going to lead to a superbug infections. First, you usually have to be incredibly sick before you’re at risk, usually your immune system has to be substantially weakened, and hospitals monitor and attack these infections when they do occur. Further, I think it is an error to classify infection with multiple-resistant strains as “iatrogenic” which would technically mean caused by medical treatment.

That’s one reason, among many, why mind-body medicine poses a brighter future than the proponents of standard drugs and surgery are willing to concede. (The fact that the average American over 70 takes seven prescription drugs a day must make anyone pause.) The public already trusts alternative medicine far more than the official voices who warn against it year after year. One reads of the dire effects of vitamin A poisoning, for example, when in reality the number of megavitamin overdoes in this country is minuscule compared to the thousands of people who get sick and die from hospital infections. It’s like condemning nutmeg as a hallucinogen while and ignoring the crash of five jumbo jets.

A brighter future? By what measure? This reminds me of the cdesign proponentsists constant promises of forthcoming research into ID. Show us some data or you’re just being a quack.

The last half is again just an example of the selection pressure for ineffective treatments for altie medicine. You probably can trust most quack remedies to do nothing, and therefore be pretty safe. And lots of people each year do die in hospitals, therefore hospitals must be dangerous killers of the innocent! Or, maybe, lots of people die in hospitals because that’s where the sick people are, and you know what? No one lives forever. Eventually, something gets you.

Chopra makes it sound like a 20-year-old who goes into the ER to get stitches is going to die of MRSA. What this ignores is that hospitals are responsible for taking care of people who are actually really sick, often very old, and frequently near death. In other words, hospitals take care of patients that no altie practitioners in their right mind would touch with a ten-foot pole, you know, those with real sickness. If you actually look carefully at the reports that the quacks cite to show how dangerous hospitals are, it’s really a reflection of just how incredibly sick and likely to die the patients were in the first place. What is one of the biggest iatrogenic killers for instance? Decubitus ulcers. In other words, bed sores that don’t heal. Very sad, and completely preventable, these usually result from inadequate nursing home care or staff monitoring of patients (rare in good hospitals). But they’re also a sign of a patient who can’t even move under their own power. I’d like to see how altie practitioners can do better than evidence-based types with patients who can’t even move. If they have a crystal that works better than regular turning of a patient, I’d like to see it.

Chopra’s final appeal is again to this individualized medicine, which they can never seem to describe better than “people are different”. It’s also a straw-man against medicine. Doctors do take into consideration individual patients. We take a family history, a personal history. We assess an individuals risk. We’re not robots who measure a couple variables that chuck drugs at you. We tailor drugs to individuals far more than the alties will ever give us credit for.

I’ve come to feel that the argument will never be settled until we accept a fact of nature: everyone has a unique response to disease. No single treatment can be expected to cure or prevent illness with complete reliability, and even if Western medicine is right to claim that a drug like penicillin works more often than any alternative, Eastern medicine can point to drug intolerance, side effects, and expense as considerable drawbacks. (Not to mention the exponential risks that often mount when pharmaceuticals are mixed with one another, or with alcohol consumption.) Therefore, each of us needs to consider our own bodies, our own life history, and our own susceptibility. Mainstream medicine constantly tries to sell its one-size-fits-all position, and it shouldn’t.

See what I mean? This guy supposedly has an MD right? I don’t know what quack foreign medical school trained him, but in the United States they teach you to take a god damn patient history, and how drugs interact with each other. “Eastern medicine”, since it does nothing, has no concern about drug interactions. Nothing + nothing still equals nothing. Until one of these alties writes down a consistent explanation for how they detect “individual illness” better than us, and then prove the predictive power of this skill, I think we’re safe with the current explanation that these people are just full of shit.
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Comments

  1. #1 Jason Failes
    November 27, 2007

    “In the East it is more easily accepted that each patient is unique, and therefore one cannot expect that the same therapy will lead to the same results in everybody.”

    But regular everyday medical science already takes this into account. Early studies into the health benefits/risks of coffee consumption were confusing and apparently contradictory until medical science discovered that there are substantial genetically-based differences in how individuals metabolize caffeine.

    Individual differences are routinely discovered in clinical trials and controlled experiments. Those same trials and experiments also often reveal the nature of those differences and how to identify them.

    Chopra has nothing more than an excuse for why homeopathic methods never seem to exceed the efficacy of chance alone.

    (It reminds me of the skeptics definition of theology: The art of finding new reasons to believe long-disproven nonsense)

  2. #2 Valhar2000
    November 27, 2007

    Yes, individualized medicine, such as the idea that ALL cancer is caused by a liver fluke, right? Goddamn I hate these hypocrites! I tell you, there is no lie on god’s green earth so big that an altie won’t tell it.

  3. #3 qetzal
    November 27, 2007

    I liked this line:

    [E]ven if Western medicine is right to claim that a drug like penicillin works more often than any alternative, Eastern medicine can point to drug intolerance, side effects, and expense as considerable drawbacks.

    Chopra as much as admits that woo doesn’t work, but argues we should use it anyway because it has fewer side effects.

    Priceless.

  4. #4 Evinfuilt
    November 27, 2007

    Hold on, with the above quote. But uhm, don’t a lot Eastern “doctors” using penicillin too, and have been for a long time.

    Does that mean Chopra thinks they’re nuts for figuring out something like that. They get things right once in a while, science then shows they got it right and we live happily ever after.

    So if I’m following him, just because we agree he can’t use it. I’m confused, I’m very confused. Heck, writing this out doesn’t help me understand his thinking.

    I guess I see that too much. That a natural remedy is a basis of our scientifically proven remedy, but the Woo’s have to ignore it.

  5. #5 Dustin
    November 27, 2007
  6. #6 Orac
    November 27, 2007

    Great minds think alike. By coincidence, I did a bit of commentary on this Choprawoo as well. From my perspective, the “individualization” of treatments claimed by advocates of alt-med is usually just a fancy way of saying, “We make shit up as we go along.” Worse, Chopra’s whole “mind-body” schtick smacks of blaming the victim of disease. An ugly implication lurking just beneath his emphasis on claiming that the mind can heal the body in such spectacular ways is that the person who remains ill and cannot “heal” himself must lack the will to do so.

  7. #7 Orac
    November 27, 2007

    Oops. Screwed up the tag. Hopefully Mark will fix it. However, I do have one more comment on this bit:

    What is one of the biggest iatrogenic killers for instance? Decubitus ulcers. In other words, bed sores that don’t heal. Very sad, and completely preventable, these usually result from inadequate nursing home care or staff monitoring of patients (rare in good hospitals).

    I’d argue that they are not “completely” preventable by any stretch of the imagination and not necessarily the result of inadequate care. Yes, certainly you’re correct to point out that rates of decubitus ulcers are much lower with better care, but they cannot be entirely eliminated, nor are they “rare” even in the best facilities. One famous example is Christopher Reeve, who clearly had the money to get the best nursing care in the world after he became a quadriplegic and still died of sepsis due to an infected decubitus ulcer.

  8. #8 MarkH
    November 27, 2007

    Orac, quite right. There are some patients that are nearly impossible to protect from decubitus ulcers, although I still think that they should be considered preventable 99% of the time. The usual case of a patient that is nearly impossible to protect is the comatose or immobile older person who has lost a great deal of lean body mass. They have no tissue between their bones and whatever surface they’re laying on, pressure prevents blood flow (they had poor circulation to begin with), absent blood flow causes necrosis, and the ulcer forms.

    When the woos talk about the 100k people killed by doctors a year, one has to remember much of the iatrogenic causes of death are things like this – sequelae of medical treatment in fragile old patients who are very ill, and will often die no matter what you do. Technically its iatrogenic. The more important metric rather than “deaths” should be “years of life lost”, a much better measure of the impact of medicine on mortality. If doctors keep you alive until you’re 80 and then kill you, it’s not the same as killing you at age 20. Even so it will always look bad for doctors because the inevitable truth is that people die in hospitals. No one dies in a homeopathic facility, because they would never in a million years be stupid enough to try to treat an pneumonia in a 96 year old, or put a chest tube into a trauma victim (or wave a crystal over a hemothorax). They know they are ideally relegated to tricking the healthy, and it’s the real doctors who treat people who actually need help.

  9. #9 Brendan S
    November 27, 2007

    You know what burns me about Alties like Chopra? Appeals to the East. Everything is better over in Asia!

    This is my favorite Eastern Medical belief:

    http://en.wikipedia.org/wiki/Fan_Death

    But, it from the east! It must be great…. Right?

  10. #10 Carrie
    November 27, 2007

    what does “woo” stand for?

  11. #11 Graculus
    November 27, 2007

    what does “woo” stand for?

    it’s the American pronounciation of “ooooooh”

    As in “Ooooh-comma-space-wow”

  12. #12 Andrew Wade
    November 27, 2007

    what does “woo” stand for?

    It’s the sound of something mis-teer-ious.

  13. #13 scienceteacherinexile
    November 28, 2007

    I don’t like the east/west tags on medicine. I know how they came to be, but there are plenty of real doctors and scientists in the east who are doing some phenominal work (remember the stem cell research from Japan last week). Again, I think most people know what is being referred to, but some “easterners” should take offense to the label, IMHO.

  14. #14 Fnord Prefect
    November 28, 2007

    I think a lot of the appeal of the eastern woo is a ‘grass must be greener’ after being through an often unsatisfactory experience with ‘western’ (ie fact based) medicine. I have no problem with western medicine, but some of its practitioners, like any profession, are awful. I’d bet everyone has personal experience or close family who have been forced to wait long periods only to be sent home misdiagnosed after a cursory, uncaring examination. So they go to a fraud who shows sympathy. I am sure that angered any doctor reading this, and perhaps rightfully so, but in my opinion some of your colleagues have done more to spread this nonsense than idiots like Chopra simply by being bad at their job.

  15. #15 Skemono
    November 28, 2007

    The fact that the average American over 70 takes seven prescription drugs a day must make anyone pause.

    Not really, since it’s real science (you know, the kind that helps us discover, test, and improve these prescription drugs) that allow this person to live to over 70 in the first place.

  16. #16 Graculus
    November 28, 2007

    think a lot of the appeal of the eastern woo is a ‘grass must be greener’ after being through an often unsatisfactory experience with ‘western’ (ie fact based) medicine.

    More like exoticism… if it’s exotic, it must be good.

    See “civet shit coffee”

  17. #17 Ex-drone
    November 29, 2007

    Brian: You are all individuals!
    Crowd: YES, YES, WE ARE ALL INDIVIDUALS!
    Brian: You are all different!
    Crowd: YES, WE ARE ALL DIFFERENT!
    Lone Voice: I’m not.
    Person next to him: SHH!

  18. #18 Citizen Deux
    November 29, 2007

    Okay – I am with you on this one. Chopra is one of my favorite public speakers – but he is a misguided as a discount North Korean missile. Medicine (like most observable events) falls into the “proven” and “unproven”. Unproven can be further divided into “net yet proven” and “disproven”. There is no East / West, there is only science and critical assessment. To wave the faux banner aspiring to “higher vibrations” is only to cloud the discussion.

    I wish he would stick to simple spirituality.

  19. #19 melospiza
    November 29, 2007

    Fnord Prefect has a point.

    Alternative medicine isn’t going to go away, whether it’s chiropractic, naturopathy, acupuncture, homeopathy, Chinese herbs, foot reflexology, reiki, faith healing, or ionic footbaths. For a few reasons: first, modern medicine doesn’t help with a lot of things. A physician doesn’t have much to offer a patient with moderate arthritis, for instance, except drugs whose side effects are often worse than the pain. Go to five different doctors with a handful of complaints like eczema, uterine fibroids, insomnia, plantar fasciitis, and migraines, and you’ll end up with five different treatments. It’s an art as much as a science.

    Secondly, everything heals some of the time. Placebos heal some of the time. Belief heals. What’s the mechanism? The mind and body really are one, and they heal and deteriorate together. Just look at asthma.

    Thirdly, alternative medicine practitioners tend to spend a lot of time with their patients. They listen and sympathize and pay attention. That’s something most doctors don’t have time to do.

    None of this is to say that woo-woo medicine is worth the vial it’s packaged in. But there is an appeal, and denying that appeal, and denying that modern scientific medicine is inadequate and risky, isn’t going to help. It’s just that, like the Constitution, it’s the best we have.

  20. #20 Pieter B
    November 29, 2007

    Well, dang. I had cataract surgery, and was seeing much more clearly in a matter of a few hours, when I could have treated myself ayurvedically at home by eating carrots, applying pumpkin-flower juice to my eyelids, putting honey in my eyes, eating about a half-ounce of aniseseed every day, pressing the eyes several times a day with the palms of my hands, and practicing yogic breathing. Oh, and don’t forget that

    In some science like Ayurveda, something called “Netratarpana” works wonderfully in which there will be herbal infusion is made and kept around the eyes by making pool.

  21. #21 Brad
    December 3, 2007

    Thanks for this post. Several years ago, I was heading to a party on a Friday night, and that boob Chopra was on the radio on some NPR show. (Can’t remember which one, but I don’t even think it was that woowoo show with Michael Toms, can’t think of the name of the show.) I was so angry by the time I got out of the car, I just ranted and raved when I got to the party and the alcohol. Fortunately, many at the party were sympathetic, adn I think I was even able to give some there some food for thought. Like what you say, most of his output is such vague blather that we can ignore him. But sometimes, he starts in on something that requires refutation.

    The typical response that these idiots make is to claim that we have implied somehow that allopatric medicine is perfect, beyond reproach. Which leads me to the only substantive point I want to make here: when you say, “We tailor drugs to individuals far more than the alties will ever give us credit for,” that point is certainly well-taken, but what’s more, we actively seek out these differences. WE discovered that gender and race sometimes make profound (and quite surprising, non-intuitive) differences in treatment efficacy, and WE seek to know in precisely what ways our individual and categorical differences do and DO NOT affect treatments. Just in past year I can think of numerous cases where we have made sometimes subtle and sometimes profound advances on just this score. That is, we make PROGRESS, often gradual but sometimes wholesale, in KNOWING which differnces effect treatment efficacy and which don’t, and (importantly) in being able to JUSTIFY our claims to progress in a way that everyone who takes the time to learn the basics of logic, chemistry, biology, and statistics (among a few others) can fully partake in.

    As Lakatos would put it, Western medicine is a progressive research programme. No other medical “programmes” meet this simple standard, and as Chopra illustrates so well here, most don’t even seem to understand it.

    Here’s an alternative hypothesis: Maybe boobs like this are just seeking to generate more business for you ‘bad’ western doctors–after all, listening to Chopra ALWAYS makes my blood pressure rise!

  22. #22 FukChopra
    December 4, 2007

    Chopra is a complete nutjob. Inside that veil of niceness churns a turbid maelstrom of broken logic chains. He is completely and utterly motivated by an incoherent faith, and in order to prop up his stupid house of cards, he will use anything and everything he possibly can convince people to believe.

    After all, he’s only got to fool some of the people all of the time. One’s born every minute.

  23. #23 FukChopra
    December 4, 2007

    ‘Nother thing. We should consider a small but noisy boycott of Huffpo’s advertisers. This crap has gone far enough, let’s see if we can hit them in the pocketbook. Anyone up for it?

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