Respectful Insolence

Media medicine: Arghh!

I sometimes wonder if those doctors who do health segments for various TV news outlets are “real” doctors, given the sorts of things they actually say. Oh, Dr. Dean Edell is a pretty evidence-based guy most of the time (one of his finest moments being his takedown of Dr. Lorraine Day on the air), but for all too many of these other docs, their brains shut down when the TV lights shine on them. Sadly, there were a couple of doozies of examples this week.

First up is Val Wadas-Willingham, producer for CNN’s medical news on Paging Dr. Gupta:

My husband’s best friend, Hans, was supposed to be in our wedding. But three weeks before the ceremony, Hans learned he had testicular cancer. He was 38. The prognosis wasn’t good. The cancer had spread to his lungs, part of his stomach and his liver. We visited Hans a few days before we left on our honeymoon. He looked awful, and we were not optimistic that he would be alive when we returned. In a cold and dingy hospital room, we bowed our heads and prayed for our friend. The doctor who was treating Hans came into the room too, and the three of us held hands and prayed together.

By the time we got back from our honeymoon he was sitting up in bed. Six weeks later he would walk out of that hospital, minus part of his lung, and he would live way beyond the number of years the doctors had given him. I believe it was a miracle. Now, I have another friend who is a Harvard-educated scientist who will tell you that no miracle took place. He’s an atheist and believes that everything that happens can be explained scientifically. He would say that God didn’t save Hans, but rather, the doctors did. In many ways I can’t argue. Hans was treated with a cutting-edge vaccine designed to fight testicular cancer, much like Lance Armstrong’s treatment. But there was something in that room the night we prayed that makes me believe it was more than just a vaccine that kept Hans alive. I believe prayer, hope and faith had an awful lot to do with his healing.

She then blathers on about how “lots of studies” have been done on the effect of prayer, credulously saying that “a good many” have shown that believers are “healthier” (the evidence for this is riddled with problems and dubious at best). For a topper, she writes:

But I will never forget that day in that hospital, when three people joined to ask for help from a higher power. I believe prayer works.


This is the freakin’ Producer for the Medical News for one of the two biggest cable news outlets saying that prayer can heal the sick! Even if Wadas-Willingham believes this to be the case, it is highly inappropriate to be stating as much on an official CNN blog, which is represented as a “behind the scenes look” at the Medical Unit at CNN. Does CNN support her view that prayer heals? (Probably, if it thinks it’ll make money.) Now that I know this is what’s going on “behind the scenes,” I realize that CNN’s medical reporting is almost certainly even less reliable than had previously thought. After all, if the producer is saying that she believes that non-evidence-based prayer (i.e., woo) “works” in spite of studies (a couple of which he mentioned) that found otherwise, while incorrectly asserting that the literature supports the contention that religious people are healthier than nonreligious people, thus revealing her utter lack of critical thinking skills and ability to assess the medical literature, then why should I trust her judgment about the medical stories that CNN reports? However, I must respectfully disagree with PZ‘s take on this, where he states that the real cause of her husband’s friend’s improvement beyond what was expected was sympathetic magic. No, no, no, no! Why not take her at her word that it was prayer and that the Big G intervened personally to save her hubbie’s friend, at least for a while (although why the Big G didn’t see fit to do the whole job and cure him completely, rather than leaving it half done, is an uncomfortable question)? Heck, why not do her one better? If Wadas-Willingham really believes that intercessory prayer heals in spite of the literature that says it doesn’t, I suggest that, the next time illness strikes her or her family, she or her family member should forego all that unnecessary modern medicine and/or surgery that just get in the way of the healing process and rely only on prayer instead.

Good luck with that. Religious people who are ill may find that prayer and prayers for them by others give them solace, and that has value, but that’s all.

If CNN’s medical correspondent, neurosurgeon Dr. Sanjay Gupta, has any shred of self-respect (or respect for evidence-based medicine, at least), he should slap his producer down publicly–something that will never happen, of course. Another thing that will never happen is the appearance of a bitter tirade against God the next time one of Wadas-Willingham’s relatives or friends dies or suffers grievous illness. It’s funny the way that God always seems to get the credit when things go well but never seems to get the blame when they don’t.

The second case that irritated me is local, from a New York station’s medical reporter Dr. Holly Phillips‘ credulously reporting on the alleged benefits of Masuka honey (video of the segment is available there too). As my wife will testify, I became rather agitated upon seeing the segment, which began like this:

Already popular overseas, a type of honey with antibiotic properties is catching on in the United States.

Some say Manuka honey, only found in New Zealand, has naturally occurring properties which can assist your body against harmful bacteria.

“I have never endorsed anything in my life, but I’m telling you this honey works,” says Joseph Schilling, a chef who uses the honey to heal burns on his hands, among other things.

He says a spoonful a day has also cured his acid reflux without traditional medicine, allowing him to enjoy his favorite foods again.

“I had lasagna the other night, and I wasn’t up all night,” he said. “That’s the exciting part about this honey.

Honey enthusiasts say its antibiotic properties come from enzymes released by bees when they make it, and it’s being used to treat everything from stomach ailments to skin sores.

“It’s an organic, natural preventative,” says Fiona Nelson of Wedderspoon Organic, a company that imports the honey.

“It’s been overwhelming. People have told me it’s changed their lives,” she said.

But research on the honey is limited.

Emily Rubin, a dietician at Thomas Jefferson University Hospital, says there is no evidence that Manuka honey can replace traditional antibiotic treatments.

Yep. Testimonials and confirmation bias. That’s all that’s there. It followed the script for media coverage of alternative medicine to a T, including the absolutely essential appeal to popularity (“it’s popular overseas” and it’s coming here); the appeal to its “naturalness”; the requisite two or more testimonials; an appeal to ancient knowledge (the ancient Greeks used honey for medicinal purposes, always a nice touch, only surpassed by saying that it was used in ancient China or by Native Americans); and, most importantly, the five second soundbite from the token skeptic, in this case, Emily Rubin. I’m not kidding. She was on camera for at most six seconds. Sadly, this really is the script for most TV news stories about “alternative” therapies: lots of testimonials, no studies, and a brief blurb from the token skeptic whose words are overwhelmed by those of the credulous.

For the record, there is evidence that Manuka has antibiotic properties and that dressings impregnated with it can be efficacious in the treatment of chronic wounds, although there are no randomized studies comparing Manuka honey to standard wound care modalities, just small uncontrolled case series; so we really don’t know if it’s any better than how we normally treat these wounds. There is zero evidence for or against the honey as an aid for gastroesophageal reflux. Unfortunately, testimonials are not anecdotes, and, even if they were, the plural of “anecdotes” is not “data.”

If you wonder why people believe in woo so much and have so little clue about evidence-based medicine, you have but to look at how these issues are reported in the media to see one major reason why. Between credulous producers who believe despite published medical studies saying otherwise that intercessory prayer plays a major role in healing and telegenic but bubble-headed physicians willing to report whatever such producers think the audience wants to hear, it’s a wonder that evidence-based medicine ever gets reported at all.

On occasion, I’ve been known to daydream about being one of these talking head physicians doing these stories, leaving aside the fact that I’m not telegenic and that I have a face perfect for radio and a voice that’s best for blogging. (It’s a fantasy, remember.) Of course, even if those obstacles were overcome, I wouldn’t last past one or two segments about any alternative medicine. Even if I could tone down my skepticism considerably, to the point of nonsarcastic wishy-washy-ness, that wouldn’t be enough. If I expressed a skeptical, strictly evidence-based viewpoint, the audience would soon be calling up the station demanding my firing, and I’d be tossed out of there on my behind.

Easy.

Comments

  1. #1 sailor
    April 12, 2007

    I sweeten my tea and coffee exclusively with honey. Never done a damn thing for may acid reflux. Prilosec works though.

    That medical column was truley aweful, and the earlier comments showed how woo people are. However they may not be a fair sampling as I added a an anti woo comment and it was not posted.

  2. #2 Ginger Yellow
    April 12, 2007

    To be honest, I was more perturbed by the fact that a medical news producer thinks a “vaccine” can a) treat testicular cancer and b) cure already metastasised cancer.

  3. #3 Rev. BigDumbChimp
    April 12, 2007

    Orac,
    I’ve heard this company selling honey for all kinds of cures simliar to what you detailed before. BeeCeuticals. Their advertising (on the Howard Stern show of all places, I think his cousin owns it or something) is full of all the same wooness. Testimonials, “it’s an ancient cure just rediscoverd”, doctors around the world are starting to use it…. blah blah.

  4. #4 Andrew Dodds
    April 12, 2007

    Actually, there is a fair amount of work going on with cancer vaccines..

    http://cancerimmunity.org/v5p1/040913.pdf

  5. #5 jeff
    April 12, 2007

    When the local news here aired their honey story (with several of the same shots it sounds like) they also mentioned that the honey goes for over 30 dollars a jar.

  6. #6 Karen
    April 12, 2007

    Jesus and his disciples as well as numerous people of faith healed well into the 3rd Century. Christian Scientists have been doing it for over 130 years. Many cases of medically diagnosed terminal diseases have been healed through prayer alone. Mary Baker Eddy whose seminal work, Science and Health with Key to the Scriptures was and is highly regarded as an important woman in the U.S. Check the religion out at http://www.spirituality.com.

  7. #7 Roy
    April 12, 2007

    It’s worse than you think. Most actual practicing doctors (the ones in your yellow pages) have wacky ideas, too.

    Almost every family doctor preaches the health value of weight loss and the simplicity of achieving it — while the same batch of doctors are all overweight. Where are the controlled studies supporting these ‘faiths’?

    Many doctors advice taking multivitamins and a variety of specific vitamin supplements, while there is no evidence to support this.

    I could go on and on.

  8. #8 Dunc
    April 12, 2007

    Between credulous producers who believe despite published medical studies saying otherwise [...]

    I really don’t think the producers give the least toss whether it’s true or not. The only concern is ratings. And I mean that absolutely literally – I don’t think the question “Is this true?” ever even occurs to them in their professional capacity. It’s out of bounds.

    I’m constantly perturbed that so many otherwise fine thinkers seem to have this persistent notion that corporate media outlets (as institutions) care at all about anything other than profitability. They don’t. If they think they can make more money by telling you the sky is green and fairies live up your nose, that is exactly what they’ll do.

  9. #9 Prometheus
    April 12, 2007

    Orac,

    It seems incredible to me that Val Wadas-Willingham would attribute her friend’s “cure” to prayer rather than the two other items she mentions:

    [1] the “…cutting-edge vaccine designed to fight testicular cancer…”

    and

    [2] the removal of “…part of his lung…”

    Perhaps, at the time, it was a dramatic change from the usual prognosis for testicular cancer, but it is not all that uncommon now – with pretty much the same treatment as was described.

    So, rather than attribute her friend’s improvement to a new therapy that worked, she takes the “woo” train and assumes that it was her personal “in” with God that led to the recovery.

    What unmitigated arrogance to think that it took her prayers to finally wake God up so that he/she/it could address an individual’s medical issues. Does she think that this man’s family wasn’t praying? Or that the man himself wasn’t praying for a cure? But no, it took the “special” prayers of Val Wadas-Willingham and her husband-to-be to convince God that this man’s life was worth saving.

    This is the problem that I have with the concept of intercessory prayer: why would it take the prayers of another person – or several other people – to convince God to intervene? Does God use polls to decide who lives and who dies? Do people who die of their cancer just not have enough people who care about them and pray for them?

    Isn’t God paying attention?

    Prometheus

  10. #10 EvilMonkey
    April 12, 2007

    Dunc is right.

    All they care about is ratings. I worked on a TV program at my previous place of employment for Discovery Health. During its production, I was actually told “Don’t worry about making it medically accurate, just make it look pretty.” It made me furious… and still do to this day when I think about it.

  11. #11 S. Rivlin
    April 12, 2007

    It is true that God is not to blame for anything that goes wrong, but is given all the credit for everything that goes right. I remember shortly after an awful car accident in which two drunk teenagers were killed hitting a tree with their car. Their classmates in the Christian school they attended, interviewed on TV, all claimed that their dead friends “are in a better place now” and that the accident was God’s wish.

    As long as God trumps science, scientific and madical advances will be minimized and God the Great will get the credit.

  12. #12 Dawn
    April 12, 2007

    Don’t have the references with me here at work, but I remember vaguely from my pharmocognasy (sp?) studies that honey (any kind) does work well on some open wounds, to prevent infection and promote healing as the sugar causes cellular death from osmosis and then the wound heals with the eschar. Also…IIRC….it was often used in the Civil War and WWI in battlefield dressings to help prevent infection of wounds. I’ll see if I can find the information when I get home tonight if it’s not too late. But saying only one type of honey? Woo supreme. And no, I don’t use honey on my wounds.

  13. #13 Ginger Yellow
    April 12, 2007

    This is the problem that I have with the concept of intercessory prayer: why would it take the prayers of another person – or several other people – to convince God to intervene? Does God use polls to decide who lives and who dies? Do people who die of their cancer just not have enough people who care about them and pray for them?

    Isn’t God paying attention?

    I offer you the best ever Onion story: God Answers Prayers Of Paralysed Little Boy – ‘No,’ Says God

  14. #14 Calli Arcale
    April 12, 2007

    I am a Christian, and I believe prayer works. Just not in the way these people think it does. A lot of people seem to regard God as a supernatural Santa Claus, whose main function is to grant wishes. But the overwhelming evidence, both scientific and scriptural are that you can’t just pray for something and expect it to magically happen. Very well-designed studies have conclusively proven that praying for something doesn’t make it happen, and frankly, I find very little theological basis for assuming this either.

    So how do I think prayer works? Well, if you know people are praying about you, and if you’re praying for yourself, it can make you feel better. And if you feel better, you will be better able to cope with the trials facing you. In the case of serious illness, this means stress relief. And studies have shown that stress relief (regardless of where it comes from, whether prayer or watching fun stuff on TV or knitting socks or whatever) seems to be correlated with better patient outcomes. There are common-sense reasons to expect such a thing; at the very least, if you’re in a good mood you’re more likely to remember to take your medicine, get some exercise, eat right, and get enough sleep.

    The other way prayer can help is that if someone prays for you, they are thinking about you. If they are thinking about you, they’re more likely to remember to stop by and cheer you up occasionally, and more likely to make sure you’ve got everything you need and are being properly looked after. So there’s a point to prayer, and a positive effect from it. But one should not expect miracles. Evidence has conclusively demonstrated that this is not how the world works.

    So what’s wrong with this theologically? Well, the Bible has a character who *does* grant wishes. It’s not God. It’s the Devil. Whether one believes in the Devil as an actual entity or not, there’s a clear lesson in the Bible stories, and that’s to be suspicious of anyone offering to take care of all your problems for you. Interestingly, I find this lesson to be very pertinent when it comes to woo, as one of the biggest red flags of woo is when something claims to be a panacea.

    The Bible also suggests that God works through other people (as does the Devil). If you do good for someone, you are doing God’s work. So the proper scriptural interpretation of someone getting better after hospital treatment (in my opinion) is simply that the doctors did a very good job. God works through them; shunning them in the expectation of a miraculous recovery would be extremely foolish (arrogant, even), yet that’s what the promoters of “the power of prayer” often encourage.

  15. #15 khan
    April 12, 2007

    This is the problem that I have with the concept of intercessory prayer: why would it take the prayers of another person – or several other people – to convince God to intervene? Does God use polls to decide who lives and who dies? Do people who die of their cancer just not have enough people who care about them and pray for them?

    And for that matter, what happens if people of different religions pray for the same person?

    Do Protestant prayers count as ‘1’ and Catholic prayers as ‘1/2’?

    Do Jewish prayers count as ‘1/4’?

    Are Muslim prayers negative?

    What if Christians pray for a Hindu?

  16. #16 Fluffy
    April 12, 2007

    I’m no chemist, but I always kind of just knew that honey was naturally antibiotic. How do I know this and Dr. Holly doesn’t? It’s inherent to the substance, as I understand it. Says wikipedia: “Honey has a very high sugar concentration and because of this it kills most bacteria by crenation. Natural airborne yeasts cannot become active in it because the moisture content is too low. Natural, raw honey varies from 14% to 18% moisture content. As long as the moisture content remains under 18%, virtually no organism can successfully multiply to significant amounts in honey” http://en.wikipedia.org/wiki/Honey

    So if you’re going to try to heal yourself with it, get the $1 bottle from wal-mart, don’t bother with the $35 fancy stuff.

  17. #17 Brian
    April 12, 2007

    Honey is naturally antibiotic in the same way very salty water is naturally antibiotic. No bacteria can grow when osmotic pressures are that high. It does not mean that honey or salt water are particularly good for wounds. Soap is probably going to do a lot better job than honey or salt water. It is, however, still possible that honey contains some kind of microbicidal substance.

  18. #18 sailor
    April 12, 2007

    Calli Arcale
    You make a good point when you say social support (and conceivably belief, though that is a more complex subject) can lower stress and help recovery. Not only do we know this but lots of the mechanisms and chemistry is well understodd. There is an excellent book on the subject by Sapolsky called “Why Zebras don’t get ulcers”. I found it quite fascinating – it is for the general reader and very readable.

    However you also say: So the proper scriptural interpretation of someone getting better after hospital treatment (in my opinion) is simply that the doctors did a very good job. God works through them.

    Why should that be? Doctors are well trained to deal with medical problems within the bounds of our knowledge. They should be able to help. There is no logical or evidencial reason to suppose that there is a god or that this has anything to do with it.

    How could you tell whether a doctgor was working on his own, or God was working through him. If there is no way to tell – if it is untellable, then it is a quite meaningless idea.

  19. #19 tim gueguen
    April 12, 2007

    Its funny we hear so much “it was God’s will” when prayer doesn’t work, and not more “Well, since prayer didn’t work it means your faith wasn’t strong enough/you’re not moral enough.”

  20. #20 Dangerous Bacon
    April 13, 2007

    Well, the chef used that miracle honey, ate lasagna, and WASN’T UP ALL NIGHT! What kind of proof do you need, skeptics?

    Warning to Orac: Keep ragging on Dr. Lorraine Day and you will be in deep doo-doo! She has warned of the CONSEQUENCES:

    “For those of you who are attacking me or the TRUTH I am telling, please be warned that there are SERIOUS consequences for you: you immediately will be placed on my Prayer List and I will pray for you daily!”

    A chilling thought.

    http://www.drday.com/rumors/consequences.htm

  21. #21 Mr. Gunn
    April 13, 2007

    I found dramatic proof of the power of prayer in this article from the St. Petersburg Times, nominated for best headline of the year by The Register, entitled “God fails to save idiot in lion enclosure.

  22. #22 Calli Arcale
    April 13, 2007

    “Why should that be? Doctors are well trained to deal with medical problems within the bounds of our knowledge. They should be able to help. There is no logical or evidencial reason to suppose that there is a god or that this has anything to do with it.”

    Very true. I don’t want to draw this too far offtopic in a theological discussion, but one thing that doesn’t get enough attention these days is the question of “what is the Kingdom of God”? Ask the “Left Behind” crowd, and they’ll describe some mystical thing where a divine Jerusalem literally descends from the heavens, squishing whatever it happens to land on, and then the righteous get to squish the unrighteous. Evidently these people think a kingdom is about brutally subjugating dissenters, which is a bit disturbing, really.

    My pastor has explained a different interpretation to me. He’s a really interesting guy, and he is very serious about his faith, and about the importance of questioning it constantly. (Critical thinking applies. It’s the only way to guard against human arrogance, including one’s own.) He went into a long explanation discussing linguistics and culture, a lot of which went over my head because I don’t speak Hebrew or Greek or Aramaic. But his assertion was that the “Left Behind” crowd have got it horribly wrong. The kingdom of God isn’t something magical; it’s right here with us now. “Thy kingdom come” doesn’t mean “hey, get down here, God, and squish all these dratted unbelievers”. It means “let me be loyal to your kingdom”, that is, let me live as you want me to live. From many of the things Jesus said, it’s clear that this means helping others. So, anytime someone helps someone else, they are choosing to do God’s work.

    It isn’t God making them do it. I believe very much in free will. And God isn’t making them any better at it, or magically augmenting their skills. But when they choose to save a life, they are doing the work of God, whether they know it or not. In fact, one could well argue that a person who doesn’t know they are doing the work of God has a purer heart, because they have no ulterior motive for caring for others. They are truly doing it for the right reason — because it needs to be done.

    From a scientific viewpoint, this is meaningless, as you say. I bring it up mainly to demonstrate that when religious folks get all worked up about “the power of prayer”, they are frequently not only wrong scientifically, but religiously as well. (At least in my opinion.)

  23. #23 Laser Potato
    April 18, 2007

    I just eat honey cuz…it tastes good… o.o
    Yeah, honey’s shelf life (for eating) is practically indefinite because it’s pretty much all sugar. Sugar, plant pheremones, and bee barf. :D

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