Respectful Insolence

Orac gets e-mail from time to time. This time around, a person working at The Ohio State University writes about a disturbing incident there demonstrating yet more evidence that academic medical centers are having increasing difficulty distinguishing between evidence-based medicine (which they should champion) and non-evidence-based medicine, which they should not. This e-mail comes from someone who wishes to remain anonymous:

Time after time I’ve read Orac’s accounts of woo infiltrating the medical community. Last month I witnessed its encroachment into the Ohio State University. Each year the university engages in a fund raising charity campaign to encourage its students and staff to contribute to a variety of causes. Listed among AIDS education, literacy campaigns, free clinic funding, and a variety of medical research causes is The Center for Wholeness. A brief glance at its website will find that its description of scientific healing includes “Shiva/Shakti Synthesis” and a variety of Tantrik methods to establish “balance between the Sun and Moon” and help our “internal landscapes.”

There are a number of ways in which this sets a harmful precedent, and I have personally written to inform our university’s president and fund raising chair of as much. First, a state institution should not be engaging in fundraising for religious endeavors. (The appearance of “Shiva” in Shiva/Shakti Synthesis is not coincidental.) Second, the university should not be identifying woo as science. An academic institution ought to value scientific rigor and not compromise its medical integrity by endorsing this sort of thing. And possibly the most practically disturbing is the danger that these contributions may be in direct tradeoff with worthwhile causes. After all, in a list of specific medical causes, a donation to a blanket medical fund might be an easier decision than choosing between funding diabetes and Crohn’s research. The promotion of the Center for Wholeness as a medical charity puts it on par with established medicine, thereby making it in direct competition for donations.

My response was met with the Associate Vice President’s claim that traditional western medicine was limited and that spiritual approaches are actively being pursued through OSU’s Center for Integrative Medicine.

If anyone is interested, President Gordon Gee (gee.2@osu.edu), Melvin Shipp (shipp.25@osu.edu), Joseph Alutto (alutto.1@osu.edu), and Larry Lewellen (llewellen@hr.osu.edu) are chairs of this fund initiative who may need to hear from other concerned voices. I’ve entertained the idea of soliciting religious groups to appeal for funding, hoping that resulting discrimination suits might prompt more responsible standards. But the direct approach of vocal criticism might present a more likely scenario for policy change.


As a University of Michigan graduate, I can’t help but feel a bit of schadenfreude over this bit of news, but I have to temper that with the knowledge that the University of Michigan Medical Center is probably ahead of The Ohio State University in permitting woo into its hallowed halls, although there does appear to be a lot of woo in OSU’s Center for Integrative Medicine (no homeopathy, though, thankfully). Also, I acknowledge that one could argue that the Center for Wellness is primarily teaching yoga, which can be good low-impact exercise, although there does appear to be a lot of woo there as well.

The inclusion of a yoga studio with a heavy Tantrik component in OSU’s fundraising drive doesn’t bother me so much in and of itself, as it could simply have been an oversight or due to lax standards for inclusion in OSU’s list of charities. Also, yoga is probably a relatively harmless type of woo, and it can at least be a good conditioning method. More disturbing to me is the attitude of the OSU leadership when questioned about this, which is antithetical to an academic, scientific, evidence-based approach to medicine. If that attitude is not reversed, we’ll almost certainly see OSU moving closer to this.

Comments

  1. #1 jenn
    November 9, 2007

    Orac…. omg…. UofM alum? As a proud OSU alum, maybe I should stop reading your blog? Hehe. Will you be watching the game next weekend? Go Bucks!! Hey, at least the Big 10 gets to have SOME kind of presence in the BCS.

  2. #2 PalMD
    November 9, 2007

    My aura is maize and blue. I think.

  3. #3 Coin
    November 9, 2007

    OSU is a state entity, no? I’d be curious, frankly, whether there is an establishment clause issue here. Government entities may of course give donations to religious groups, and here the government entity isn’t even giving the donations itself. But there are limits, of certain kinds…

    Also, it would be interesting to get a full quote on exactly what the associate vice president said. It seems to me like it would be news, of a sort, that the associate vice president of OSU thinks that “western medicine is limited” and “spiritual” approaches are needed. Were I an OSU student this is an administrative philosophy which would lead me to wonder certain things about the student health services.

  4. #4 N.B.
    November 9, 2007

    I’m kind of curious about the prevalence of this sort of thing in public versus private universities. Does anyone know if it’s more common in public universies or vice-versa? It’s all about PR and money, and it’s generally the administration that seems to be interested in pushing these kinds of agendas; I imagine most of the science faculty, if they’re worthy of their jobs, is retching in a corner somewhere.

  5. #5 David B.
    November 9, 2007

    Orac, I don’t agree with the tone of your article and, Coin, I don’t think you’re being fair to the OSU VP.

    Western medicine largely does not understand pain and soft tissue injuries, especially when it involves long term inflammation, or the best non-chemistry-set way to treat them. There are a long list of documented and researched ways to provide relief, accelerated healing, and minimize shock related to meditation and prayer. To my mind these are all biofeedback techniques.

    Just because western medicine can’t quantify and qualify it does not mean it is without merit.

    I can’t defend or condemn the OSU fundraising situation with the Wholeness organization, there is insufficient information in what has been presented. For all I know use of “Shiva” could be intended to qualify the specific techniques used, that have been derived from a ceremony or process of the religion, while the religion itself has no part in the therapy or philosophy of technique.

    But I can say this, Integrated Medicines departments have been and are popping up in major university connected medical centers/enterprises all over North America. For a long time these centers have been the dumping ground for physicians that fix things with bone saws and extreme chemistry. They are producing results – not the least of which have been bio-feedback therapy through meditation physiotherapy and prayer.

    I think you’re jumping to conclusions without sufficient information to do so in an informed way.

    http://www.theskinofmyteeth.com

    David B.

  6. #6 Koray
    November 9, 2007

    I don’t think anybody is jumping to conclusions whenever “spiritual” approaches are being investigated. May the force be with you.

  7. #7 Sastra
    November 9, 2007

    There are a long list of documented and researched ways to provide relief, accelerated healing, and minimize shock related to meditation and prayer.

    If so, then “Western” medicine accepts them as part of “Western” medicine. Why wouldn’t it? “Western” medicine means “scientific medicine.”

    If it still rejects them, then there just might be something a little inflated or flawed with that “long list” of scientific validation.

  8. #8 DLC
    November 9, 2007

    Want to add prayer to your healing? Reiki? holding Magic Wands Fine. Feel free to do so on your own. But I draw the line at mandating that these things be included in the practice of teaching medicine. They don’t belong there.

  9. #9 Dan
    November 9, 2007

    Orac writes: “I can’t help but feel a bit of schadenfreude.” Being of German decent I cannot help but like the use of the term schadenfreude. My wife gets off on it a lot and she holds German citizenship. Back on topic, even a little woo might not be bad if it causes the placebo effect. That has to have some benefit. If I could have some witch doctor dancing around and it make me feel better, why not? I agree only science should be taught in a medical school. But let us admit if these techniques induce the placebo effect, then in must have some, however, fuzzy benefit.

  10. #10 bug_girl
    November 9, 2007

    I have just about given up on this fight. The worst was when my university listed Tulane’s School of Tropical Medicine in with all the Acupuncture schools at our graduate school fair.

    Apparently “oriental medicine” and “tropical medicine” are the same thing to them :(

    My protests against the naturopathic and other woo schools being allowed to attend this fair for Graduate Programs were shot down with “some students want that, and we are providing a resource.”

  11. #11 daedalus2u
    November 9, 2007

    The actual benefit of the placebo effect is quite specific (and limited). It derives from restoring physiology to the “rest and relaxation” state, a “standing down” from the “fight or flight” state where resources are diverted from repair and healing into such things as “running from a bear”. If you are already in that state, a placebo can’t do anything extra. The adverse effects of stress are due to being in the “fight or flight” state where resources are diverted away from repair and healing. Anything that reduces stress and resets physiology to the rest and relaxation state will improve long term health.

    There can be detrimental effects of the placebo effect as well, for example nausea is made worse by the placebo effect. I discuss this at length in my blog on the placebo effect.

    http://daedalus2u.blogspot.com/2007/04/placebo-and-nocebo-effects.html

    The placebo effect improves conditions that are made worse by low nitric oxide, and worsens conditions made better by lower nitric oxide (there are actually very few of these which is why placebos (and woo) seem to work for just about everything).

  12. #12 Ex-drone
    November 10, 2007

    David B. writes

    I think you’re jumping to conclusions without sufficient information to do so in an informed way.

    Wrong way around. Don’t teach a “promising” technique at medical school because you want to keep an open mind and because it might work. Instead, first do the research, replicate the results and publish in a peer-reviewed journal, then teach the proven technique at medical school. I think you’re jumping the gun without sufficient information to instruct in an informed way. Science is not closed to new ideas, but they do have to prove themselves.

  13. #13 The Crack Emcee
    November 10, 2007

    Orac,

    You got my attention with these two statements:

    “The Center for Wellness is primarily teaching yoga, which can be good low-impact exercise, although there does appear to be a lot of woo there as well.”

    And

    “Yoga is probably a relatively harmless type of woo, and it can at least be a good conditioning method.”

    First, on the point of Yoga as exercise, TIME magazine’s recent article on the subject, When Yoga Hurts, that states:

    “The truth is, yoga, regardless of the form, doesn’t offer a comprehensive way to get fit. According to a study by the American Council on Exercise, a national nonprofit organization that certifies fitness instructors and promotes physical fitness, dedicated yoga practitioners show no improvement in cardiovascular health. It’s not the best way to lose weight either. A typical 50-min. class of hatha yoga, one of the most popular styles of yoga in the U.S., burns off fewer calories than are in three Oreos–about the same as a slow, 50-min. walk. Even power yoga burns fewer calories than a comparable session of calisthenics. And while yoga has been shown to alleviate stress and osteoarthritis, it doesn’t develop the muscle-bearing strength needed to help with osteoporosis.”

    Second, as you know, I don’t think there’s such a thing as a “harmless type of woo” because (as I found out the hard way) cultists act on their beliefs away from the medical setting, as well, causing all kinds of grief to others. But (sticking just to the effects on an individual practicing Yoga) there’s the phenomena known as “Kundalini Madness” to consider, which was described by Carl Jung in the Introduction to The Tibetan book of the Dead :

    “One often hears and reads about the dangers of Yoga, particularly of the ill-reputed Kundalini Yoga. The deliberately induced psychotic state, which in certain unstable individuals might easily lead to a real psychosis, is a danger that needs to be taken very seriously indeed. These things really are dangerous and ought not to be meddled with in our typically Western way. It is a meddling with Fate, which strikes at the very roots of human existence and can let loose a flood of sufferings of which no sane person ever dreamed. These sufferings correspond to the hellish torments of the chönyid state…”

    Activating the kundalini is, of course, Yoga’s true purpose – not exercise – and it’s been making people spiritually stupid for 1000s of years. Some of the symptoms (I copied from a website) include:

    • Muscle twitches, cramps or spasms. 

    • Energy rushes or immense electricity circulating the body

    • Itching, vibrating, prickling, tingling, stinging or crawling sensations

    • Intense heat or cold

    • Involuntary bodily movements (occur more often during meditation, rest or sleep): jerking, tremors, shaking; feeling an inner force pushing one into postures or moving one’s body in unusual ways. (May be misdiagnosed as epilepsy, restless legs syndrome (RLS), or PLMD.) 

    • Alterations in eating and sleeping patterns

    • Episodes of extreme hyperactivity or, conversely, overwhelming fatigue (some CFS victims are experiencing Kundalini awakening)

    • Intensified or diminished sexual desires

    • Headaches, pressures within the skull

    • Racing heartbeat, pains in the chest

    • Digestive system problems

    • Numbness or pain in the limbs (particularly the left foot and leg)

    • Pains and blockages anywhere; often in the back and neck (Many cases of FMS are Kundalini-related.)

    • Emotional outbursts; rapid mood shifts; seemingly unprovoked or excessive episodes of grief, fear, rage, depression

    • Spontaneous vocalizations (including laughing and weeping) — are as unintentional and uncontrollable as hiccoughs

    • Hearing an inner sound or sounds, classically described as a flute, drum, waterfall, birds singing, bees buzzing but which may also sound like roaring, whooshing, or thunderous noises or like ringing in the ears.

    • Mental confusion; difficulty concentrating

    • Altered states of consciousness: heightened awareness; spontaneous trance states; mystical experiences (if the individual’s prior belief system is too threatened by these, they can lead to bouts of psychosis or self-grandiosity)

    • Heat, strange activity, and/or blissful sensations in the head, particularly in the crown area.

    • Ecstasy, bliss and intervals of tremendous joy, love, peace and compassion

    • Psychic experiences: extrasensory perception; out-of-body experiences; pastlife memories; astral travel; direct awareness of auras and chakras; contact with spirit guides through inner voices, dreams or visions; healing powers

    • Increased creativity: new interests in self-expression and spiritual communication through music, art, poetry, etc.

    • Intensified understanding and sensitivity: insight into one’s own essence; deeper understanding of spiritual truths; exquisite awareness of one’s environment (including “vibes” from others)

    • Enlightenment experiences: direct Knowing of a more expansive reality; transcendent awareness

    Of course, the victims of Kundalini Madness don’t like to talk about it, for a variety of reasons, and the so-called yogis certainly aren’t going to promote it (bad for business) but, most importantly, doctors absolutely shouldn’t be endorsing Yoga. To those of us that follow cultish activities, it is considered a “gateway drug” to paranormal interests, and cult involvement, leading predictably to a lack of common sense that can cause the kind of tragedy that befell a Brooklyn college professor not too long ago.

    I’d like to stress that, as you discuss woo topics, you might want to give some thought to the “collateral damage” that’s inflicted on those around the believers in such things. As a member of that demographic, I can tell you it pains me (sometimes) to read articles that simply regard the doctor/patient dynamic as the only one that should be taken seriously when CAM is the issue. These are delusions, and the people that hold them, many times, have loved ones who are struggling, alone, trying to convince them they’re wrong in their beliefs, while medicine is either endorsing them or cracking jokes at their expense. Both approaches, to me, are wrong and wrong-headed. I think it’s about time for science, and medicine, to throw down the gauntlet – however that may be done – and follow the lead of your colleague, Panda Bear, M.D. (who seems to be the only blogging doc to recognize you have various forms of a “CAM cult” on your hands) in openly declaring to patients and hospitals alike:

    “You have become a tad too open-minded. So open minded that you no longer have the conceptual tools to distinguish the right from the wrong, the good from the bad, or the reasonable from the ridiculous.”

    The time really has come to get serious.

  14. #14 Dangerous Bacon
    November 10, 2007

    “Just because western medicine can’t quantify and qualify it does not mean it is without merit.”

    Ah, a classic woo-ism. Or as it is sometimes stated, “Absence of evidence is not evidence of absence” – which when translated means “I ain’t got nothin’.”

    Not the sort of inquiring attitude that _The_ Ohio State University needs to have.

  15. #15 Chris
    November 10, 2007

    As a recent alumnus of tOSU, this is outrageous; believe me, they’ll be receiving complaints from me.

  16. #16 daedalus2u
    November 10, 2007

    Crack MC, your mentioning of Kundalini Yoga is extremely interesting to me in the context of my ATP regulation and NO physiology research. It appears to me that the state induced by Kundalini Yoga is very similar to the extreme “fight or flight” state of a near death experience. To me, this is a similar state as is brought about during things such as “running from a bear”. Fundamentally I see it as a low ATP state, where the body then enters an emergency survival mode. Non-essential systems are shut down (such as the immune system, cellular repair, digestion), freeing up ATP for immediate consumption in things like muscle.

    This is (what I think) results in acute psychosis induced by stimulents of abuse, and is the cause of postpartum psychosis which I discuss in my blog.

    http://daedalus2u.blogspot.com/2007/08/low-nitric-oxide-acute-psychosis.html

    I see all of the symptoms you mention as being due to low NO and low ATP. This acute state is an extreme version of the “runner’s high”, the delusion that one is not tired. What is the “runner’s high”? Does a new emergency energy source come online when normal metabolic reserves are exhausted? No, if there was such an emergency energy source cells would have evolved to use it all the time. No, what happens is that energy consumption is reduced. Involuntary pathways are turned off diverting ATP to voluntary pathways.

    I see this as much the same as the acute psychosis induced by PCP, which is also usually accompanied by hyperthermia (as is the Kundalini state). I think in both cases the hyperthermia comes from mitochondrial uncoupling which disipates the mitochondrial potential as heat, and can actually turn mitochondria into ATP consumers not producers. This lowers ATP levels and the lower ATP level turns off “low priority” pathways. The way it is induced, by restricting breathing, may induce hypoxia which produces superoxide, destroys NO, lowers ATP levels and triggers the physiology of the “near death experience”. The near death state must necessarily be an euphoric state, so as to allow the organism to continue to “run from a bear” even with broken bones and other major (but yet fatal) injuries. It is an extremely dangerous state to invoke because all the normal “safeties” that prevent injury (or running yourself to death) have been disabled.

    Invoking the Kundalini state in an attempt to heal, would be like giving amphetamine or , PCP or cocaine. People may “feel” better in the short term, but that is a delusion. I have no doubt that you could measure reduced cerebral ATP via magnetic resonance spectroscopy. This state would be as addictive as taking the actual drugs would be.

    This is not the type of mental state induced by meditation as practiced by the Dalai Lama. That is a high NO (and so high ATP) state which does activate healing.

  17. #17 AnonymousOSUemployee
    November 11, 2007

    Coin posted: Also, it would be interesting to get a full quote on exactly what the associate vice president said. It seems to me like it would be news, of a sort, that the associate vice president of OSU thinks that “western medicine is limited” and “spiritual” approaches are needed.

    Unfortunately, although I can address general positions stated to me, I am unauthorized to directly quote my own correspondence. In my experience, he did take careful time to write back and answer additional concerns I had made. That being said, I’d encourage anyone to ask for their official position on “spirituality” and its role in our school’s medical regiment.
    Since Orac posted this, a lot of discussion seems centered on the merits of yoga. I wanted to know if it is conceded that this is an act in which the state is sponsoring and coordinating funds for a religious organization. It seems to me that “spirituality” funds with specific mention of deities is rather blatant.
    I’m with Orac in understanding benefits of exercise, allowing yoga to be considered beneficial by default. I believe this goes beyond promotion of yoga as exercise, however. I encourage people to look at the texts posted by the Center for Wholeness [http://www.cfwohio.org/sib-suryanamaskar.php] to explore the claims they are open about.
    In my experience, organizations like this are a sort of “gateway” to other potentially dangerous endeavors.

  18. #18 Jim Lippard
    November 11, 2007

    Do any universities have a Center for Incompleteness (perhaps with faculty from the computer science, mathematics, and philosophy departments) to compete with this Center for Wholeness?

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