Respectful Insolence

Having lived in Ohio for eight years and married a woman from the Toledo area, I had come to think that Ohioans had more common sense. I guess I was wrong.

On the other hand, I should have realized that I was wrong. After all, Ohio is home to The Ohio State University Center for Integrative Medicine and the Cleveland Clinic Department of Integrative Medicine. So much for hard-nosed Midwestern skepticism, I guess. My only consolation as a University of Michigan graduate is that Ohio seems to be trying to surpass Michigan for promoting woo in academia. Or it would be were it not that a major force for woo in academic medicine is my old alma mater, the University of Michigan itself.

Sadly, though, I need to add another university to my (in)famous Academic Woo Aggregator. Woo Aggregator, say hello to the University of Cincinnati Medical Center. University of Cincinnati Medical Center, say hello to my leetle friend–I mean, my Academic Woo Aggregator:

CINCINNATI–Often, a gentle hand on your shoulder when you’re upset is all it takes to ease your mind and calm your nerves.

Now, UC researchers are looking at a similar occurrence by pairing a complementary therapy known as Healing Touch with mild sedation to see if the technique truly calms patients undergoing minor procedures.

Healing Touch is a series of techniques that balance energy for wholeness within a person’s body, mind and soul. It is an energy therapy that can be used in conjunction with other traditional medical treatments.

Ugh!

I know this is a press release, but geez Louise! “Balance energy for wholeness within a person’s mind, body, and soul”? Give me a break! This is not science. This is woo. But let’s see. Maybe–just maybe–this prose was the result of an overzealous copy writer in U. of C.’s media relations department. After all, no real researcher would talk about adjusting one’s energy, right?

Wrong:

Nathan Schmulewitz, MD, the lead author of this investigator-initiated study and assistant professor of digestive diseases, says people undergoing procedures often have problems falling asleep because of anxiety.

Schmulewitz specializes in endoscopic ultrasound (EUS), a technique for imaging and accessing deep structures in the chest and abdomen which are near the GI tract. EUS is used as a screening tool for cancer or other suspicious polyps.

He says if a patient is unable to fall asleep with intravenous sedation, it might be necessary to use stronger anesthesia which is expensive and not often covered by insurance companies.

“In addition, stronger sedation can prolong recovery for the patient and can cause slight amnesia following the procedure,” Schmulewitz says.

This study is looking at whether coupling Healing Touch with mild sedation prior to an EUS procedure can help relax patients, avoiding problems with anesthesia and making the procedure run more smoothly.

Dr. Schmulewitz looks like a fine young academic gastroenterologist. His webpage lists his clinical and research interests as endoscopic ultrasound, GI oncology, IBS (irritable bowel syndrome), and pancreatic disease. So how on earth did he get mixed up in this woo? Here’s how:

Judy Bowers, a nurse at University Hospital, Healing Touch practitioner and co-author of the study, has been doing this therapy for about seven years and has administered it to over 40 patients involved in this study.

“By restoring balance within the energy system, you create an optimal environment for healing,” Bowers says. “This is complementary medicine, not alternative medicine, so it can be easily incorporated in a medical model.”

Here we go again with the “restoring balance within the energy system” woo again! But it’s even more seriously out there than that:

Although there are many healing touch therapies, this study is only looking at three: the Chakra Connection, which facilitates movement of energy from one energy center to another, Magnetic Clearing, which clears the field of congested energy, and Mind Clearing, which involves a light touch on the face, head and neck.

Once again, whenever I hear any “healer” discussing manipulating the “movement of energy” for “healing” purposes, especially when it’s the variety of woo known as therapeutic touch, I remember that this is woo so easy to demonstrate to be worthless that even a nine year old girl could do it. I’m referring, of course, to Emily Rosa, who was nine years old back in 1998, when she undertook a study that was actually published in the Journal of the American Medical Association (JAMA). The design was simple yet powerful in that it tested the concept at the heart of therapeutic touch; i.e., that human beings have an “energy field” and that practitioners can manipulate this energy field in order to induce therapeutic or “healing” effects.

Remember, therapeutic touch (or healing touch) has little to do with actual touch. It’s not massage therapy, which at least feels very good and can be quite relaxing, as anyone who’s ever had a massage can tell you. Rather, touch practitioners barely touch their clients and claim that, by having their hands over the patient, coupled with the occasional gentle touch, they can alter the flow of life energy in the patient and thereby produce a therapeutic affect. Just look at the website for the Healing Touch Program, which describes it thusly:

Practitioners use their hands with light or near-body touch to help clear, balance and energize the human energy system, thus promoting healing for the mind, body and/or spirit.

Back to Emily Rosa. She reasoned that if touch practitioners could detect a human energy field then they could detect which of their hands was closer to an investigator’s hand. During Emily’s test, several experienced practitioners rested their forearms and hands on a flat surface with their palms up, approximately 10 to 12 inches apart. Emily would then hold her hand, palm down, a few inches above one of the subject’s palms. The practitioners correctly located Emily’s hand only 122 (44%) out of 280 trials, which is no better than would be expected by random chance alone. Even more tellingly, there was no correlation between the practitioner’s score and length of experience. The conclusion was clear: Experienced practitioners could not detect whether a hand was near one of their hands any better than they could by guessing. They could not detect any “energy fields” or anything else related to the central claim of “healing” or “therapeutic touch,” for that matter.

Of course, the more rigorous the study, the less of an apparent effect is observed for healing touch. It’s a lot like homeopathy that way. It’s also a lot like homeopathy in that the alleged “scientific” basis postulated to support healing touch is roughly equally as improbable as the incredibly improbable “scientific” basis of homeopathy, known as the “memory” of water, a memory that, if you believe homeopaths, not only can retain characteristics of any substance the water has come into contact with but can transmit that memory through absorption through the GI tract and somehow impart it to the body through no molecular interaction that’s ever been characterized.

This leads me to ask whether this particular study is of adequately rigorous scientific design to produce results that have any validity whatsoever, regardless of what its results turn out to be. The answer, not unexpectedly, is no:

As part of the study, a third party calls the patient two days after the procedure to ask a number of questions about how Healing Touch affected the patient during the EUS and recovery.

The results are being analyzed, but Bowers says she’s observed some fairly positive responses.

“Some of the patients are asleep before they even receive the intravenous sedation,” she says, noting that she stays with patients throughout the procedure in order to continue sharing her energy with them and maintaining the balance.

I could be wrong, but this description it certainly sounds as though this is an uncontrolled, unblinded study, probably with leading questions in the “survey.” Even if it is controlled (again, which it appears not to be), at the very least the study’s participants do not appear to have been blinded to what treatment group they are in. Of course, we all know (or should know) what uncontrolled, unblinded studies of “alternative” medical therapies almost always show, don’t we? Yes, thanks to the placebo effect, observation bias, and a number of other confounding factors, such studies are virtually always “positive.” If Ms. Bowers’ study did not include blinding of the patients and Dr. Schmulewitz to whether patients were receiving “true” healing touch or not, it’s guaranteed to produce a seemingly positive result. One wonders why anyone even wastes the time and money.

I see an article heading straight to the Journal of Complementary and Alternative Medicine.

It’s sad to see this sort of shoddy and credulous “testing” of woo at an academic institution as respected as the University of Cincinnati. Apparently, U. of C. also has a highly organized “complementary and alternative” medicine curriculum for its medical students as well. On the other hand, searching the U. of C. website, I’ve been unable to find an organized department or program in woo. From this observation I conclude one of two things: Either there is no organized program at U. of C.

Or possibly U. of C. actually has a sense of shame.

Comments

  1. #1 Tim
    July 8, 2008

    Bad news, as I’ll be attending UC this fall…
    At least I’m not attending the med school.

  2. #2 Yoo
    July 8, 2008

    If they are going to research woo, the least they can do is to use a rigorous design for the study and to concede that it doesn’t work if no effects are detected. Too bad that this study looks like it’s designed to confirm an effect even when there is none.

  3. #3 Paul Schofield
    July 8, 2008

    Sorry that this is off topic, but just an amazing statement on this new article;

    Acupuncture ‘no help for IVF’

    Dr Sunkara said that, based on the evidence she had analysed, she would not advise her patients that having the therapy could improve their chances of having a baby through IVF.

    But Paul Robin chairman the Acupuncture Society, said: “I’m really surprised by these findings.

    “I’ve been treating people for twenty years and in my experience treatment does seem to improve their chances of becoming pregnant.

    “This study has shown that there’s no proof that acupuncture can help – so that suggests that there should be lots more studies to examine the question.

    “I’m convinced it can help.”

  4. #4 Yoo
    July 8, 2008

    Paul Robin just removed all doubts that he’s a hack …

    (In my experience, those who delve in woo woo are delusional, have faulty thought processes, and are very dumb. The difference is, I admit I could be wrong, at least about the “very dumb” part, and won’t be stubborn in my belief if enough evidence surfaces supporting the contrary.)

  5. #5 Jonathan Vos Post
    July 8, 2008

    My career at Woodbury University, after 5 semesters as extremely successful Adjunct Professor of math, respected by faculty and students, was ended at the orders of the Chairman of Physics and Math, who had an Ed.D. from University of Cincinnati.

    He was a nasty man, and is still Chairman. he yells at students, forces everyone else in his department to work insane hours while he has an easy schedule. He has only 1 refereed Physics paper — and the junior co-author of two extremely prolific Chinese and Korean authors who probably gave up and accepted that he was making no contribution.

    But he has the school jet him to nonsense conferences to present nonsense papers, which have no statitisical analysis of their non-double-blind anecdotal data.

    I, on the other hand, have mnore publications that the rest of the department, in fact than the rest of the Division, combined.

    His EdD dissertation (which I don’t think he wrote) claims a theory for how to teach Physics. That theory has failed in the classroom every semester for a decade.

    He ordered the actual Physicist in the department to teach by his woo-ful methodology. The Academic VP finally intervened, saying that the actual scientist could teach the subject her own way, and not be saddled with the Chairman’s woo.

    That actual Physicist has literally 10 times as many Google Scholar publications shown than the Chairman, who continues to harass and insult her.

    I’ve written to the Dean at University of Cincinnati. No reply received.

    Obviously there’s an imbalance in the energy field there.

  6. #6 Bourgeois_Rage
    July 8, 2008

    As a UC grad, I will be expressing my distaste for this ‘study’ to my Alma Mater. Orac, thank you for bringing this to my attention. UC prides itself on good science and engineering programs, which makes it that much more disappointing to see such nonsense peddled to students.

  7. #7 Oldfart
    July 8, 2008

    The mention of this study in ScienceDaily caused me to finally cancel my rss feed from them along with a nasty email. ScienceDaily, which I have accessed for years, has become more and more a woo feed and not a science feed.

    Also, watching a program on the so-called Health channel last night with my wife, we were inflicted with an ad for a homeopathic arthritis remedy. I’d like to know just how they get away with that. (I’m sure there are other homeopathic remedies offered on the so-called Health channel in the past but this is the first one that I noticed used the actual term “homeopathic” as if it was a good thing). That will get the Discovery Health channel another nasty email from me which won’t do any good (except for lowering my bile level temporarily).

  8. #8 Citizen Deux
    July 8, 2008

    Here is a thought – although I am as Woo averse as one can get – is there ANY correlative evidence that the presence of a practicioner has some biochemical / neurochemical effect on the patient? For example, it is known that an individual’s performance in certain tasks can be enhanced by the presence of an observer.

    Do these researchers simply lack the skill necessary to distill any possible benefit from their actions? I realize the variables at play are literally innumerable – but there could be some reasonable, repeatable explanation.

  9. #9 Oldfart
    July 8, 2008

    The only enhancement an observer gave to my performance as a typist in high school was to turn my fingers into fists causing keyboard jams and multitudinous errors.

  10. #10 S. Rivlin
    July 8, 2008

    Is there a correlation between Ohioans voting in the presidential elections of 2000 and 2004 and their beliefs in woo?

  11. #11 Paul Hutch
    July 8, 2008

    Episode 2 of this seasons Penn & Teller’s Bullshit!, “New Age Medicine”
    , has good coverage of TT nonsense starring Emily Rosa and Dr. Barrett.

  12. #12 D. C. Sessions
    July 8, 2008

    Of course, we all know (or should know) what uncontrolled, unblinded studies of “alternative” medical therapies almost always show, don’t we? Yes, thanks to the placebo effect, observation bias, and a number of other confounding factors, such studies are virtually always “positive.”

    Maybe it’s time to fight woo with woo. Take the exact same study design, only use it with something else. Ideally, something which will, upon detailed disclosure, be profoundly objectionable.

  13. #13 StuV
    July 8, 2008

    DC, you might have something there. I vote to all-out Godwin the sucker and investigate the therapeutic effect of waving pictures of Hitler at the back of the patient’s head.

  14. #14 Alan
    July 8, 2008

    As a native Ohioan, this doesn’t surprise me, especially considering the recent addition of coverage for “alternative” therapies by Toledo-area healthcare providers (See: Alternative goes mainstream: Local healthcare systems incorporate holistic medicine from the Toledo City Paper). As you could guess, healing touch is among them.

    The article features profoundly stupid nuggets such as:

    “I think we can expect a great marriage between the two disciplines.” agrees Dr. [Ron] Shapiro, [pain management specialist at Mercy’s Center for Integrative Medicine and Wellness]. “I see further documentation of these alternative practices in the coming years. Already acupuncture has lost its mystical reputation because we understand the physiological principles behind it. Hypnosis is another example. I expect we’ll learn more of the science behind other ‘mysterious’ practices like healing touch and prayer as well. As practitioners validate these techniques, you can look for third party candidates such as insurance providers to start recognizing these benefits in their policies.”

    And to top it off, it was a cover story!

  15. #15 DT
    July 8, 2008

    I remain mystified as to why practitioners of the dark arts always assume their “manipulation of energy fields” are good, and will automatically lead to “healing”.
    How do they know they are not permanently screwing up some vital inner bioenergetic mechanism of homeostasis that might result in cancer in 5 years time?

  16. #16 varkam
    July 8, 2008

    @ DT:

    No doubt. I’m sure that there’s some “extensive training” they have to go through in order to make sure that they don’t screw it up.

  17. #17 Skeptico
    July 8, 2008

    ..by pairing a complementary therapy known as Healing Touch with mild sedation…”

    Yeah, I think if they were going to try Healing Touch on me I’d probably need some form of chemical sedation too.

  18. #18 zeediva
    July 8, 2008

    This business with “energy fields”, etc., really is so much woo. I wonder, however, about the placebo effect of touch therapy: tell me this will make me calm down, and I do.

    Or, because I was nurtured as a child and held and caressed when I was in pain, would touch therapy reach into my psyche and pull out the learned response I now have to touch under duress — kind of like “kissing a boo-boo”. Perhaps that’s what’s really going on here.

    Someone’s making money off of it, and that’s the bottom line anyway.

  19. #19 Dangerous Bacon
    July 8, 2008

    “”In addition, stronger sedation can prolong recovery for the patient and can cause slight amnesia following the procedure,” Schmulewitz says.”

    As someone who’s had “stronger sedation” for endoscopies, I can attest that amnesia for what happened during the procedure (and for a short period afterwards) is a nice thing.

    Here’s hoping that insurance companies don’t decide to forego paying for decent anesthesia on the theory that cheaper “healing touch” can decrease the need for drugs. If someone pulls that crap on me, they’re gonna need an extended course of “healing touch”.

  20. #20 tsig
    July 8, 2008

    You gotta sue the woo when money talks the woo walks.

  21. #21 Suze
    July 8, 2008

    I grew up in Cincinnati, and my mother was very heavily involved in a weird New Age cult that was active there in the 1970s — soul travel, planes of existence (they were on a higher one, of course), lots of reading material requiring lots of money to acquire. They weren’t big on western medicine — whole lot of aloe vera gel and rolfing going on. Woo isn’t new to the area.

    I would mention the cult’s name, except they at least used to be litigious.

  22. #22 Liz
    July 8, 2008

    If my doctor ever suggested this kind of woo, I’d walk out of her office. If my surgeon ever allowed this kind of woo in the operating room, I’d forgo the surgery.

    I want the brightest, most talented, and quick thinking scientist I can afford working as my partner in health. I’ll leave the woo masters for the masses who think they know more than the doctors. Those folks at UC appear to be cowtowing to ignorance and sponsoring a wack festival. Say goodbye to credibility folks!

  23. #23 Sastra
    July 8, 2008

    Since reality is all supposed to fit together, I’m always puzzled by the fact that people who claim that there are “energies” unique to living things don’t wonder why the people who specialize in energy — physicists and engineers, say — aren’t at all involved or interested in what would surely be an important, significant, and critical part of their area of expertise. It would be like saying that computer science technicians as a whole wouldn’t know or be curious about a stunning new technology which allows computer screens to create and project lifelike holograms into a room because it’s unique to “gaming,” and experts on computers don’t play that particular video game so they don’t care.

    From what I can tell from conversations I’ve had, Life-Energy advocates compartmentalize vitalistic energy from physical energy using the same basic heuristics they use to separate their religious views from what’s true in “the world.” Just as scientists can’t be expected to know or find out anything about the “soul,” actual physicists won’t be able to recognize or discover the special Energy Fields of Life. They think the different areas wouldn’t overlap.

    And then they consider themselves “holistic.”

  24. #24 Dr. T
    July 8, 2008

    Forget Dr. Schmulewitz’s idiotic fascination with woo, I want to discuss his incompetence as a gastroenterologist. He claims that some people, because of anxiety, cannot be sedated intravenously and might need ‘stronger’ anesthesia (presumably he means gas-based anesthesia). I only did a month of anesthesiology as an M4 25 years ago, but I do remember that you can put down an anxious grizzly bear with IV anesthesia, and you can do it faster than with gas anesthesia.

    What I believe Dr. Schmulewitz means is that a wimpy dose of IV valium is not enough to make some patients calm and tractable if they were extremely anxious about the endoscopic ultrasound. Perhaps a pre-procedure calming session would be more helpful than woo. I have observed many endoscopies (including full colonoscopies), and I never saw one (in an adult) that required anything other than IV valium.

  25. #25 Dr Benway
    July 8, 2008

    This is tangential to the topic, but I wanna share my pain with a sympathetic crowd: anyone heard of Kenneth Bock MD?

    Just got off the phone with a parent of an autistic girl under my care. She’s arranged a consultation with Dr. Bock who apparently has an expertise in the “Biomedical” treatment of autism.

    This parent states that she will have to wait many months for her consultation with Dr. Bock, but it will be so totally worth it. “He’s just amazing.”

    Teh google scare me. Mercury – vaccines – toxins – chelation – integration – healing power – wonderful anecdotes – all the usuals.

    If I do not criticize this heavy metal hypothesis, my silence may seem to lend the idea support. But if I describe the lack of controlled science beneath the chelation treatments, I will no doubt alienate this mom who will simply say, “Dr. Bock has done lots of studies….”

    Is there any hope or am I fucked?

    Wow. Check out this guy’s web store: http://www.rhinebeckhealth.com/store/

    It is Serious Business™.

  26. #26 Dr Benway
    July 8, 2008

    Back on topic:

    When I had a hysterectomy at a local hospital, I was offered a bit of post-op Reiki to aid in my recovery, free of charge.

    I said, “The thing with the hands over you to align your energies? Wouldn’t the giggling strain my sutures?”

    Woo. I do not know how to make it stop even among my colleagues. We all seem so helpless.

  27. #27 Dexter Colt
    July 8, 2008

    Having lived in Ohio for eight years and married a woman from the Toledo area, I had come to think that Ohioans had more common sense. I guess I was wrong.

    Hey! I have a healthy amount of common sense (spent 28 years of my life as an Ohioan).

    Perhaps you should start an aggregator that lists non-woo affiliated institutions. I suspect that list would be smaller and easier to maintain. Woo is a pandemic. I blame Oprah.

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