Yesterday, I concluded that Dr. Mehmet Oz’s journey to the Dark Side was continuing apace. After all, he had pulled the classic “bait and switch” of “alternative” medicine by allowing a man who calls himself Yogi Cameron to use his television show to co-opt the perfectly science-based modalities of diet and exercise as being somehow “alternative.” Like all good promoters of woo, whether you call it “alternative” medicine, “complementary and alternative medicine” (CAM), or “integrative medicine” (IM), Yogi Cameron used diet and exercise as the thin edge of the wedge, behind which followed nonsense such as Ayurvedic tongue diagnosis and Pancha Karma, the latter of which is in essence Indian “detox” involving purging and enemas, among other things. Of course, also like a good propagandist trying to popularize woo, Yogi Cameron left out the “hard” parts (like the enemas) and stuck to the softer side of Pancha Karma, such as the nasal irrigation and the “detox diet.”
To abuse my Star Wars metaphors yet again, if the featuring of Yogi Cameron on an episode of his show was the equivalent of Anakin Skywalker taking revenge on the Tusken raiders for having killed his mother Shmi, yesterday’s episode was Anakin cum Darth Vader hitting the Jedi temple and slaughtering the younglings. In other words, it definitively marks the point of no return, the point at which Dr. Oz’s journey to the Dark Side is now complete. All he needs is a Darth Vader mask. Or maybe a mask of Samuel Hahnemann. Or something.
The reason yesterday’s episode definitively marks a point of no return for Dr. Oz when it comes to his support for quackery is because he has apparently decided to follow his TV mentor Oprah Winfrey’s example in realizing that faith healing sells. Of course, Dr. Oz, as popular as he is, is not as well established as Oprah. Whereas Oprah got John of God, Dr. Oz gets a second tier faith healer. He gets Dr. Issam Nemeh, who must be very grateful to Dr. Oz, because when you look at his website, you’ll be greeted with a message:
Welcome Dr. Oz Viewers!
Dr. Nemeh has received an overwhelming response from the viewers of the Dr. Oz show. Medical office appointments with Dr. Nemeh are already filled for the next four months.
To add your name to the cancelation list, send an email with your name, phone number, and reason for treatment to firstname.lastname@example.org.
Helpfully, though, humanitarian that he is, Dr. Nemeh is still there for you:
How To See Dr. Nemeh Without a Lengthy Wait
You have the option to attend a Path To Faith Healing Services, at which Dr. Nemeh prays over each attendee. All healing services are held by Path To Faith, a separate organization. Information on upcoming healing services and ticketing can be found on their website.
Dr. Nemeh’s medical office does not provide tickets for healing service. Tickets are only available online through PathToFaith.com
But how did Dr. Nemeh get so popular suddenly? Behold the power of Dr. Oz, who did a completely credulous segment about him entitled, Is this man a faith healer?
In a word, no.
If you recall my discussion of Oprah Winfrey’s utterly credulous treatment of John of God, you might wonder if Dr. Oz did any better. Believe it or not, I actually expected that Dr. Oz’s segment about Dr. Nemeh would be harder for me to deconstruct. Indeed, I expected it to be much harder to deconstruct. Dr. Oz is, after all, a physician, and in the preview for his episode featuring Dr. Nemeh, there was a clip showing Dr. Oz with small pile of charts saying that he had asked to see the medical records of some of Dr. Nemeh’s patients. Given that and given that Dr. Nemeh is a physician himself, I figured that, between the two of them, Drs. Oz and Nemeh would be able to cherry pick cases that would be truly convincing and very difficult to refute. When that happened, I feared I’d be reduced to saying that single anecdotes are not convincing, which, while true, is a relatively hard sell to lay readers without medical training. Even some physicians remain unsatisfied by such an explanation, and it’s not hard to figure out why.
Fortunately for me (and unfortunately for Dr. Oz), I needn’t have worried. You’ll see what I mean in a minute.
The first segment begins, as usual, with Dr. Oz introducing the topic. In this case, Dr. Oz breathlessly proclaims this to be a show “unlike any other we have done before” and describes how he has been “fascinated” by this doctor in Cleveland. We’re then shown several people in the audience who claim to have been healed by Dr. Nemeh, who is described as a doctor who doesn’t use drugs or procedures but “heals with his hands.” Dr. Nemeh, we’re told, uses a “high tech form of acupuncture” in his office and the laying on of hands and the use of spirit in churches and meeting halls, all to “heal.” During this voiceover, we’re treated to images of Dr. Nemeh in action, including a paralyzed patient who claims that he’s noticed some movement in his feet since Dr. Nemeh started treating him, a woman who implied that she had her vision restored, and a woman who claims that her multiple sclerosis is gone. Dr. Oz’s chief medical correspondent, Dr. Michael Roizen, tells us that he definitely believes “there’s something here,” and Dr. Nemeh himself proclaims that his goal is to “bridge the gap between science and spirituality.” Certainly, there is a receptive audience among Dr. Oz’s studio audience, as Dr. Oz cites a poll of his audience, which reveals that 86% of them believe in the power of faith to heal.
Here’s where Dr. Oz shows a stack of medical records. Quite frankly, to me it looks like a pretty darned small stack. Be that as it may, Dr. Oz then says that he’s had his medical staff investigate the cases and that he’s talked about them with Dr. Roizen. That’s when the interview with Dr. Nemeh begins. Dr. Nemeh, it turns out, is a trained anesthesiologist who sees patients at his office in Rocky River (a suburb of Cleveland) and is known for his faith healing sessions at churches and a variety of other locales. As the interview progressed, it became clear that Dr. Nemeh used a lot of different “alternative medicine” modalities in addition to his “electroacupuncture” (which is, of course, not really acupuncture at all, but transcutaneous electrical nerve stimulation, or TENS) and prayer services. Dr. Nemeh, of course, is also represented not just as the Brave Maverick Doctor but as the reviled Brave Maverick Doctor, with even his family disapproving of what he is doing.
In the next part of the segment, Dr. Oz tells the audience to judge for themselves whether Dr. Nemeh is a faith healer on the basis of the patients of Dr. Nemeh’s whose story he will tell. Of course, as an academic surgeon (which Dr. Oz was for a long time before turning to woo and, given that he is still a professor of surgery at Columbia University, technically still is even though he long ago abandoned science in favor of nonsense), Dr. Oz should know that single anecdotes say at best little or nothing and at worst mislead. The plural of “anecdote,” as we say, is not “data.” Yet anecdotes are what he provides–and then only two of them. No science. No statistics. No scientific studies to be presented along with the human interest anecdotes. Just testimonials and utterly unconvincing cherry picked clinical test results.
First up is a woman named Cathy. Cathy is presented as having a mass in her left lung. Cathy reports that she was “so sick” and that she was coughing up blood. A CT scan is presented, which does show a worrisome mass in the lower lobe of the left lung. We are not informed whether Cathy is a smoker, which would have made me even more worried if I were Cathy’s physician. She describes a two hour visit with Dr. Nemeh, who, she reports, used acupuncture, “infra-ray light,” and prayer to treat her, after which her breathing got much better. Later, a PET scan was ordered, and the mass was gone. The problem with this anecdote, as regular readers of this blog would probably spot right away, is that there was no tissue diagnosis. In the story, it is implied that Cathy had some sort of horrible lung tumor that spontaneously disappeared. Yet her doctor violated the cardinal rule of oncology: He never got a tissue diagnosis. That mass could have had any number of nonmalignant explanations. One thing I’d worry about is tuberculosis, actually. Or it could have been sarcoidosis, or a small pneumonia. In fact, I favor the latter because, when Dr. Oz zeroes in on a close-up, I think I see bronchi going through the mass, which implies consolidation. Whatever it was, if the Cathy’s physician thought it was cancer, he should have gotten a needle biopsy. Indeed, reading between the lines, I wonder if Cathy’s doctor really thought it was cancer. The fact that he ordered a PET scan implied that he thought it might be (although infection can light up on PET as well), but his failure to obtain a biopsy implies that he either wasn’t very sure or didn’t think it was cancer.
All in all, it’s a somewhat confusing case, but there is no evidence whatsoever other than the post hoc ergo propter hoc fallacy that, just because Cathy got better after seeing Dr. Nemeh, it must have been Dr. Nemeh’s woo that cured her. To be fair, Dr. Oz points out the possibility that the mass might have been infectious in nature, but in reality he didn’t sound as though he really believed that. In fact, he came across as playing Devil’s advocate. Unfortunately, Cathy’s doctor (Dr. Kelly) was not particularly skeptical.
Next up is a woman named Dr. Patricia Kane, who is introduced as having been diagnosed with idiopathic pulmonary fibrosis in 1995 and told that she had less than five years to live. Idiopathic pulmonary fibrosis is a disease in which the lungs develop scar tissue, gradually decreasing air exchange. In Dr. Kane’s case, we are informed that she underwent a biopsy that confirmed the diagnosis. We are not really informed whether Dr. Kane has gotten better, but, as you might expect, idiopathic pulmonary fibrosis is a disease with a highly variable rate of progression that can range from a very rapid scarring of the lung and loss of lung function to slow progression even to long periods of time (years) with no progression. Overall, the five year survival is reported to be between 30% and 50%, with this caveat:
Keep in mind that researchers have noted a considerable variation in these life expectancies based on the factors that were mentioned previously.
In other words, Dr. Kane is almost certainly a person who is fortunate enough to be an outlier. Like all such patients who are lucky enough to be outliers and who chose “alternative” medicine, Dr. Kane underwent conventional therapy and Dr. Nemeh’s quackery, and after she did well she attributed her good fortune to the faith healing quackery. Again, Dr. Oz plays the “skeptic” a bit by challenging Dr. Kane gently with the possibility that the diagnosis was mistaken, which, while definitely a possibility, was not the only possibility. More likely is the possibility that, as I mentioned before, Dr. Kane is fortunate enough to be an outlier in a good direction.
Dr. Oz finishes up by interviewing Dr. Jeffrey Redinger. Remember him? He’s the same physician who was taken in by John of God, and he lays down the same sort of barrage of credulous nonsense that he did when he commented on John of God for Oprah Winfrey:
What I think at this point is that we are just not physical beings, we are also spiritual beings, physical beings need oxygen and spiritual beings need love. One research questioned I believe is whether there is a connection between love and healing? That is something that modern science is begining to tiptoe into.
Then we’re treated to what has to be one of the most pathetic faith healings I’ve ever seen. A woman named Mary Beth is brought up on stage. After she states that she has lower back problems that she attributes to arthritis, Dr. Nemeh does his thing. The best Mary Beth could come up with was that she felt “a little” better. From back pain. I don’t know about you, but I was so not impressed by this. Indeed, I was left scratching my head and thinking, “This is the best Dr. Nemeh could come up with?” You know that if Dr. Nemeh could come up with better cases, he would have brought them on the air. For instance, where’s the paralyzed patient who said he was getting some motion back? Why wasn’t his case featured? What about the woman who claims her MS is gone? Why wasn’t she featured? It makes me wonder if the evidence for these patients’ claims is even weaker than the evidence for Dr. Kane or Cathy. Not that any of this stops Dr. Nemeh from proclaiming:
You don’t have to be religious, you don’t have to have faith, you can be an Atheist, what matters is we were talking before about one very important principle, the love that we have. Because the heart of God himself is Love. No you don’t have to have any faith to be healed.
I often wonder how a man as obviously intelligent and well-trained as a surgeon as Dr. Oz can fall for such utter tripe. In his case, I suspect that it’s become more about the fame, the money, and the image that has developed as “America’s doctor.” Whatever the reason, Dr. Oz’s journey to the Dark Side is complete. When Dr. Oz left Oprah, he was but the learner. Now he is the master. The master of woo. Yes, yes, I know the analogy is flawed in that it inappropriately likens Oprah to being one of the good guys (i.e., Obi-Wan Kenobi), but I just love that line.
It’s not just Dr. Oz, though, who suffers from a profound lack of skepticism and critical thinking. It’s many physicians. After all, Cathy’s doctor apparently believed that she had been the beneficiary of some sort of miraculous healing on the basis of the thinnest of thin evidence. And he is a pulmonologist! That so many physicians fall for pseudoscience and faith healing does not speak well of our profession.