White Coat Underground

To wear the mantle of Galileo, it is not enough to be persecuted:
you must also be right.

—Robert Park

As a physician, it’s hard for me to support the absurd media fashion of presenting two, equal sides to every issue. In politics, perhaps, many debates have two equally-valid viewpoints, but this isn’t so in science and medicine. A treatment is either proven to work or proven not to work. Occasionally, plausible ideas are sitting somewhere in between hoping for evidence to push them one way or the other. Notice the word “evidence”—not waiting for the verdict of a TV talk show, not waiting for a news anchor’s opinion, but waiting for evidence. That’s why there is no such thing as “alternative medicine”; there is only that which has been shown effective, and that which has not.

In the latest “Oprah Wars”, the mainstream media have finally noticed that the Daytime Diva actively promotes quackery. Some folks are unhappy about the “unfair attacks” on their best TV friend. Those who think that Oprah is revealing secrets long suppressed by some Cabal of the FDA and Big Pharma are beyond reason. But those who think that Oprah is actually performing a service need some education.

One such person is Lee Schneider, writing at the Huffington Post. He basically falls for the infamous “Semmelweis Fallacy” also known as the “Galileo Fallacy“. This error in reasoning represents some fundamental misunderstandings of how science works (not how “they” say it should work, but how it actually accomplishes its successes).

According to Schneider:

Newsweek portrays her as laughable, but I agree with Oprah – [Suzanne] Somers might be a pioneer. Self-experimenters have often advanced science. At the age of 22, Sir Isaac Newton nearly blinded himself by staring at the sun in a mirror because he wanted to study the after-images it left on his retinas. Australian physician Barry James Marshall swallowed some foul-smelling bacterial crud to show that Helicobacter pylori caused ulcers. Sir Issac ended up with marks on his eyelids; but Marshall ended up with a 2005 Nobel Prize for linking the bacterial crud, H. pylori, to ulcers. I’m not saying Suzanne Somers is going to surprise us with a treatise on gravity, but she has courage.

Suzanne Somers, promoter of dangerous women’s health advice, will never win a Nobel Prize, and not because she is an idiot. She will never win a Nobel (or a Lasker) because she is no scientist. The Dr. Marshall to whom Schneider refers actually had a plausible hypothesis and collected data. Somers has no plausible hypothesis for her bioidentical voodoo, and wouldn’t know real data if it jumped into her notebook.

Schneider further opines:

Newsweek is going backward, contributing to the backlash against new medicine. Oprah is going forward by supporting medical pioneers. While looking into the sun, drinking crud or shooting up in the vagina may not seem so brilliant, breakthroughs come from acts of courage or folly and sometimes both.

Science is a system of understanding the real world. It’s a system that, though it has imperfections, has served us well. Simply asserting that something is so is not “being a pioneer”—it’s being a crank. To show that something is so, even something strange, one must actually study it systematically, not go on TV and assert that it is true. To assert requires no courage, only folly. And in medicine, folly kills.

Comments

  1. #1 bob
    June 8, 2009

    And HuffPo completely misses the point wrt medicine, yet again. What a mess that place is. And “New Medicine,” huh? Hardly. I think Post-Medicine would be a more appropriate moniker for the far fringe of sCAM.

  2. #2 Phil
    June 8, 2009

    Huffpo, I may like some of their politics, but when it comes to quackery they are just as bad as the right wing GOP, and that takes some trying let me tell you.

  3. #3 D. C. Sessions
    June 8, 2009

    And in medicine, folly kills.

    Alas, usually someone else.

    I mean Oprah no harm, but I am curious about this Gedankenexperiment: how would she react if it turned out that she’s been pumping herself full of synthetic estrogens — and she has a subclinical estrogen-sensitive tumor?

  4. #4 natural cynic
    June 8, 2009

    Instead of calling it alternative medicine

    call it alternative to medicine

  5. #5 Donna B.
    June 9, 2009

    @natural cynic – excellent language observation

    @Phil – I’ve often wondered how one can trust the political views of a site that so blatantly promotes woo. For me, same goes for the political views of a site that blatantly promotes ultra right wing woo… such as ID and pro-life meaning no abortion at all… or right wing “woo” as I see it.

    Evidence* is important in politics too and I’m afraid that both left and right ignore it.

    *evidence is not nearly so easy in politics as it is in medicine – history is all we have.

  6. #6 Dianne
    June 9, 2009

    Oprah doesn’t meet either criterion for the mantle of Galilleo: she is neither right nor persecuted. Being told that you are wrong is not “persecution.” Even having a major magazine write a story about how wrong you are is not persecution. Has Oprah been arrested for her views on medicine? (As Galileo was.) Has Oprah been threatened by anti-CAM crazies or had anti-CAM crazies shoot at her because of her views? (As Tiller among others was.) Has Big Pharma started a website with inflammatory anti-CAM propoganda and personal information about Oprah, Jenny McCarty, and others on it? (Again, as occurred with Tiller.) Oprah et al may be annoyed by the negative reaction in Newsweek. Their feelings may be hurt. Heck, their income from books and appearances toting their views may be hurt. But that’s not being persecuted. That’s just having an alternate viewpoint presented. And isn’t one of the basic premises of CAM that all viewpoints and alternatives should be presented?

  7. #7 Badger3k
    June 9, 2009

    “While looking into the sun, drinking crud or shooting up in the vagina may not seem so brilliant, breakthroughs come from acts of courage or folly and sometimes both.”

    Because we all know the incredible benefits these all provide, right? Although, to be fair, what is getting shot up the vagina? My first thought was drugs (shooting up, in the parlance), but is this something new that I am afraid to hear about? Russian Roulette Birth Control?

  8. #8 Badger3k
    June 9, 2009

    Actually, the comment by Dianne made me think of something – Oprah took that writer to task for lying to her (well, that is what she gave as her reasons, IIRC), but when someone lies about science, she basically just shrugs her shoulders and says, “Not my fault, people know what’s real and what isn’t” – why the double standard? Other than the fact that it is not her personally who is getting scammed, just all her viewers?

  9. #9 absurd
    June 9, 2009

    The attack on Oprah is absurd. 99% of the health advice given on her show is mainstream (i.e. Dr. Oz); the regular expert who she’s even given a show too. Once in a while she’ll have a controversial guest (Suzanne Somers) but she’s always clear to tell viewers to check with thier doctors and she always makes clear that mainstream doctors don’t approve. And people like Sommers go all over the media (Larry King, the Early show), so why single Oprah out for attack? Because she has too much influence for a black woman? Because she through her influence behind Obama back when he needed it most, and now Obama wants to reform health care? Newsweek is funded by pharmaceutical companies.

  10. #10 the bug guy
    June 9, 2009

    Huffington Post pulls out one of the “Big guns”, Deepak Chopra. You better put on your waders before clicking on the link. It’s a cornucopia of pseudoscience and poor logic.

  11. #11 bob
    June 9, 2009

    @9: Wow! A persecution complex, the race card, and a conspiracy theory. Not bad for a single paragraph! Next time, try to make your fallacies a bit more overt and work in some aliens.

  12. #12 Patient
    June 9, 2009

    @9: “she’s always clear to tell viewers to check with thier doctors and she always makes clear that mainstream doctors don’t approve”

    No, she really doesn’t do that. She might say “check with your doctor” but that is really slight of hand, as she can say “check with your doctor” with one hand yet promote the “REAL cure you need to know” about with another. Telling people to “check with their doctor” is like telling them to stop using their credit cards. It is good advice in theory, but in practice, it is more like “Check with my doctor? You mean that guy who doesn’t believe that shark cartilage cures cancer? Why would I want to spend money to see HIM when Suzanne Sommers has my cure right here for 18.95 (plus tax)?

    I feel for you PAL, and all other doctors at this point in our country’s history. I don’t know which way the wind is blowing anymore, but it sure looks like its blowing back to the era of witch doctors and magic potions and away from science and reasonable discourse.

  13. #13 aliens
    June 9, 2009

    we’re sorry. we forgot to re-align the orbital mind control laser before taking over #9′s brain.

    we won’t let that happen again.

  14. #14 Neuroskeptic
    June 9, 2009

    #9 – the fact that 99% of the time her advice is mainstream actually makes matters worse, because it means she has some credibility. If Oprah were a laughing-stock crackpot who no-one took seriously, we wouldn’t care what she said. But she’s not, she’s Oprah. She can make a book sell a million copies with a 30 second mention on her show. People do listen to what she says. And even if she says “This isn’t necessarily true, consult your doctor” the very fact that she says it at all is the important thing. (For the same reason you wouldn’t like it if I said “I hear absurd is a child abuser. Of course, I may be wrong.”)

  15. #15 ALAN HAMEL
    June 9, 2009

    SUZANNE SOMERS HAS WRITTEN 18 BOOKS, MOSTLY ON HEALTH AND HORMONES AND MANY NEW YORK TIMES BEST SELLERS.
    SHE WAS AWARDED AN HONORARY DEGREE IN LETTERS FROM NATIONAL UNIVERSITY; HER MANY BOOKS WERE CONSIDERED A THESIS.
    I HAVE BEEN WITH HER FOR 41 YEARS; SHE IS NO DUMMY. SHE ONLY PLAYED ONE..BRILLIANTLY. NEWSWEEK IS FAILING BECAUSE THEY VALUE THEIR AGENDA MORE THAN ACCURATE REPORTAGE. THE REPORTER PAT WINGERT WHO BEAT UP ON OPRAH AND SUZANNE, TOOK 5 PAGES OF THE ARTICLE BEFORE SHE ADMITTED SHE TOO HAS WRITTEN A BOOK ON MENOPAUSE BUT SHE RECOMMENDS SYNTHETIC AND VERY DANGEROUS HORMONES MADE FROM HORSE URINE; CHECK OUT THE WOMEN’S HEALTH INITIATIVE. HER UPDATED BOOK IS BEING RE-RELEASED IN SEPTEMBER.
    THE WISE PHILOSOPHER SCHOPENHAUER TALKS ABOUT THE 3 STAGES OF ACCEPTANCE.
    FIRST THERE IS RIDICULE. SECOND IS VIOLENT OPPOSITION. AND THIRD IS ACCEPTANCE. WE ARE IN VIOLENT OPPOSITION. THE MEDICAL ESTABLISHMENT HAS PLAYED GOD SINCE ALOPATHIC MEDICINE WAS BORN AND THEY DONT LIKE THE IDEA THAT NOW THERE ARE DOZENS OF STUDIES ON REAL NATURAL HORMONES THEY (AND THE NEWSWEEK WRITER) IGNORE, HOPING WE WILL ALL GO AWAY. SUZANNE SENT THE NEWSWEEK WRITER ALL THE STUDIES AND CORRECTED THE FACT THAT SHE DOES NOT INJECT HER VAGINA, BUT THE IMAGE WAS TOO SEDUCTIVE AND SHE PRINTED IT ANYWAY AND CONTINUED TO SAY THAT THERE ARE NO STUDIES.
    AND THAT IS WHY NEWSWEEK AND ALL THE NEWS ORGANS WHO HAVE AN AGENDA WILL GO BANKRUPT; THE PUBLIC IS WISE TO THEM AND REFUSES TO BUY THEIR VITRIOLIC AND HEAVY HANDED ATTACKS. THINK OF ALL THE MAGAZINES THEY WOULD SELL IF THEY GAVE SUZANNE AS MUCH SPACE AS THIS HACK WHO PROUDLY ANNOUNCED TO SUZANNE THAT SHE DOES NOT NEED ANY HORMONES; EVEN THOUGH SHE IS IN THE COCKTAIL HOUR OF HER LIFE, DOESNT SLEEP, IS ROTUND AND OBVIOUSLY BITCHY..REALLY!!
    AND BY THE WAY, IT’S PROBABLY JUST A HAPPY COINCIDENCE, BUT OVER HALF THE ADS IN THIS NEWSWEEK WERE PAID FOR BY PHARMACEUTICAL COMPANIES.
    OPRAH CALLS SUZANNE A PIONEER. OPRAH IS THE ORIGINAL PIONEER. SHE HAS THE TESTICULAR FORTITUDE TO IGNORE ALL THE CRAP THEY FLING AT HER AND JOYOUSLY CARRY ON WITH HER GREAT WORK. GOD BLESS OPRAH AND HER TEAM. AND WHILE I’M AT IT, GOD BLESS AMERICA.

  16. #16 PharmGirl MD
    June 9, 2009

    Perhaps our friend ALAN HAMEL might have had something to say above @15, but I couldn’t read it because of all of the shouting (hint — caps lock = shouting when commenting). Something about Suzanne Sommers’ books counting as a thesis…. Anyway, I’m sure that my real degrees from universities in the NE and South as well as years of research in breast cancer and hormonal influences of natural products doesn’t make me qualified to comment in his eyes.

    Cheers!

  17. #17 D. C. Sessions
    June 9, 2009

    Congratulations, PalMD — you’re getting right up there with Orac on the “bringing out the batshit crazy” scale.

    Anyone? We need an award (maybe the BatShit Signal) for blogs that draw drooling whackjobbery like this. Any artists around?

  18. #18 Denice Walter
    June 9, 2009

    @ D.C.Sessions: good idea! In the war on woo, these guys(gals) deserve the Purple Heart(metaphorical, of course).

  19. #19 The Blind Watchmaker
    June 9, 2009

    The Daily Kos had a good article highlighting the Newsweek article.

    The writer ended with a link to the Oprah website comment form. The end of the article is reproduced below.

    http://www.dailykos.com/storyonly/2009/6/7/739891/-Newsweeks-stinging-critique-of-Oprahs-pseudoscience-and-poor-medical-advice

  20. #20 Ranson
    June 10, 2009

    Wow, if that’s the real Hamel, then you managed to draw out Somers’s husband! Good work, Pal! Fame and/or fortune is sure to follow!

  21. #21 Citizen Deux
    June 10, 2009

    I wonder if anyone can tell me the ad revenue generated by Oprah’s media empire from pharmaceuticals – wanna bet it’s above average?

  22. #22 StephanieB
    June 10, 2009

    ALAN HAMEL, THAT WAS AWESOME. CRAZY, BUT AWESOME.

  23. #23 bob
    June 10, 2009

    Sheesh … every rock the SBM crew turns over, there’s more lunatics! Who knew people would go bonkers over Oprah and Lyme Disease? It’s depressing.

  24. #24 Nan
    June 11, 2009

    You do politics a disservice by suggesting that’s an area where there might be only two equal but opposite viewpoints or possible outcomes. In any given situation, there will actually be a potentially infinite number of possibilities, far more so than in science (in science there are going to be some things that are fairly quickly discerned as clearly and irrevocably wrong or impossible), and to treat the political arena as though it’s a simple choice between Policy A and Policy B with no other options on the table encourages the sort of shallow reasoning that too often characterizes politics in contemporary society.

    I’m not commenting on Oprah. The wholesale dumbing down of a wide swath of the American populace that she promotes is too profoundly disheartening to think about.

  25. #25 Lee Schneider
    June 12, 2009

    “Science is a system of understanding the real world.” I couldn’t agree more, PalMD. Nobody is saying that Oprah is a scientist. She’s a talk show show host and journalist with a point of view. As another commenter has pointed out, Dr. Oz is her go-to medical guy for the most part.

    What’s interesting to me is the intense debate that surrounds complementary/integrative medicine. There’s some pretty solid research about the benefits of reiki, for example, and for acupuncture and for the benefits of meditation. I think where somebody like Oprah helps us is by showing that the boundary between mainstream and fringe might be moving a bit. And the debate she sparks is what is helping us define the line between folly and courage. Thanks for writing about this – what you’re saying is important.

  26. #26 PalMD
    June 12, 2009

    Thanks for stopping by, Lee. I’d be curious to know what this “pretty solid research” is.

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