Quackademic medicine marches on: George Washington University and the University of Toronto

Collingewheel

Quackery has been steadily infiltrating academic medicine for at least two decades now in the form of what was once called “complementary and alternative medicine” but is now more commonly referred to as “integrative medicine.” Of course, as I’ve written many times before, what “integrative medicine” really means is the “integration” of quackery with science- and evidence-based medicine, to the detriment of SBM. As my good bud Mark Crislip once put it, “integrating” cow pie with apple pie does not improve the apple pie. Yet that is what’s going on in medical academia these days—with a vengeance. It’s a phenomenon that I like to call quackademic medicine, something that’s fast turning medical academia into medical quackademia. It is not, as its proponents claim, the “best of both worlds.”

In fact, it was my two recent publications bemoaning the infiltration of quackademic medicine into medical academia, one in Nature Reviews Cancer and one with Steve Novella in Trends in Molecular Medicine, that got me thinking again about this phenomenon. Actually, it was more my learning of yet another step deeper into quackademia by a once well-respected academic medical institution, occurring so soon after having just published two articles bemoaning that very tendency, that served as a harsh reminder of just what we’re up against. You might remember that a few months ago I noted the infiltration of a naturopath practicing traditional Chinese medicine at the once-respected Cleveland Clinic Foundation (CCF) and then just a couple of weeks ago I was alarmed at the CCF’s seemingly one-upping itself in quackery by starting a partnership with the guru of the quackery known as “functional medicine,” Mark Hyman. This was, sadly, not surprising, given the CCF’s history of integrating cow pie with apple pie, so to speak, in its “integrative pediatrics” program.

Yes, just when I thought things can’t get worse, they do. There is also room for hope in that I also found evidence that our criticisms are at least starting to be noticed.

George Washington University does the CCF one better

From my vantage point it’s depressingly true that the CCF has gotten very, very bad indeed with respect to its promotion of medical pseudoscience. Besides its traditional Chinese medicine clinic and its Center for Functional Medicine, just take a look at its Center for Integrative Medicine, which offers chiropractic, acupuncture, and the magical faith healing that is reiki. If you really want to see how far gone the CCF is, just read its Reiki Factsheet.)

Then look at the Center for Integrative Medicine at the George Washington University Medical Center (GWCIM). Compared to the GWCIM, the CCF’s integrative medicine program looks like a bastion of science-based medicine. GWCIM's list of services includes acupuncture (of course!), chiropractic, craniosacral therapy, infrared light therapies, glutathione infusions, Myers’ Cocktail, naturopathy (again, of course!), reiki, intravenous high dose vitamin C, and genetic profile results that include “customized interpretation of 23andme.com genetic profile results with specific accent on methylation and detoxification profiles.” It’s a truly horrifying website to contemplate, given how little of it has any resemblance to science-based medicine and how much of it includes outright quackery like reiki. Perhaps even the GWCIM is a bit embarrassed, because it can’t even provide a correct description of reiki:

Reiki describes both a harmonizing energy and a non-invasive therapy which involves the placing of hands in a sequence of locations on or near the body. It is not massage, as the hands remain stationary at each position.

The purpose of Reiki is to promote the client’s own natural healing process by providing deep relaxation, abatement of signs or symptoms of distress, or instilling a sense of harmony and balance. Reiki can be used in conjunction with any other treatment to enhance and accelerate its effectiveness.

No, reiki is faith healing that substitutes Eastern mystical beliefs for Christian beliefs, as I like to point out any time a discussion of reiki comes up. At least the CCF describes the magic that is the channeling of “healing energy” from the “universal source” more or less correctly.

I perused what GWCIM writes about a few other modalities, and its website’s descriptions of various alternative medicine modalities are depressingly and similarly credulous. Acupuncture is described as being used for “for treatment of respiratory, digestive, urinary and reproductive systems, as well as the disorders of muscle tone, hormone production, circulation, and allergic responses” plus “pain relief, gynecological conditions and symptoms, insomnia, anxiety, and to enhance wellness.” Naturopathy is described as a “comprehensive approach to health and healing that combines modern scientific knowledge with traditional and natural forms of medicine,” with naturopaths addressing “the mental, emotional and physical aspects of an individual, and aim to treat the root causes as well as the symptoms of illness.” According to GWCIM, naturopaths are “trained as primary care doctors at accredited four-year naturopathic medical schools.” They are not. Their training is inadequate and usually consists of as little as 20 days of primary care practice during their third or fourth years of naturopathy school. Meanwhile naturopaths embrace the four humors and tend to be staunchly antivaccine with rare “sort of” exceptions. Doesn’t GWCIM know that? Or doesn’t it care? Apparently not.

Indeed, look at what GWCIM says about high dose intravenous vitamin C therapy for cancer. After citing in vitro and animal studies that are not particularly compelling and then claiming that there are “several case reports published in peer-reviewed medical journals that meet quality standards set by the National Cancer Institute” that “demonstrate that a small number of patients have responded to a high dose IV Vit-C infusion treatment after all other treatments have failed” (which is patently incorrect, as these cases are as unconvincing as Stanislaw Burzynski cases), all the while admitting that there aren’t any compelling randomized clinical trials, GWCIM writes that in practice:

Based on a vast pool of clinical experience, IV administration of high dose Vit-C has been shown to essentially have no side effects, unlike chemotherapy drugs and radiation therapy. Since IV Vit-C works just like chemotherapy and radiation therapy by releasing free radicals, there are no contraindications for their simultaneous use. In fact, Vit-C may work synergistically with chemotherapy and potentiate its effect.

However, there are some disadvantages. The course of therapy is long and intense, two to three times per week (2 hours each) and for the duration of about a year. It can cost over $20,000 for a year-long course of treatment if it is not covered by an insurance.

When evaluating new innovative cancer treatments we need to ensure that three basic requirements are met:

One: There is a clinical plausibility, i.e., credible case reports exist.

Two: There is a biological plausibility, i.e., the mechanism of action is clear.

Three: Proven clinical effectiveness, i.e., a randomized controlled trial has been conducted.

High dose IV Vit-C therapy has met the first two requirements. It is unfortunate that it would take many years before the last step can be accomplished.

We feel compelled to offer this treatment to patients when there are no other choices even though the definitive clinical evidence of its effectiveness is not yet available.

Clinical plausibility? Intravenous vitamin C might not be homeopathy-grade implausible, but it’s not particularly plausible either. As I like to say frequently, vitamin C, even if it worked, would be a really long run for a short slide, given the incredibly high concentration of ascorbate that’s ever been shown to have in vitro anticancer activity. If vitamin C were anything other than “natural,” doctors would have abandoned it a very long time ago as far more trouble than its minimal to nonexistent promise warrants. Achieving such concentrations is difficult, and it is not without side effects, contrary to GWCIM’s claims. I therefore call nonsense on number one. As for biological plausibility, the mechanism is anything but clear. It could be generation of free radicals, but there are also studies suggesting that ascorbate could interfere with chemotherapy, as the Memorial Sloan-Kettering Cancer Center integrative medicine web page acknowledges as it says that high dose vitamin C shouldn’t be used outside of a clinical trial. I call nonsense on number two. Finally, while it’s true that there hasn’t been a large randomized clinical trial for vitamin C for cancer, there has been a phase I/II clinical trial that was basically negative, as I described earlier this year. So I call nonsense on number three as well.

In other words, there is no reason for oncologists at GWCIM to “feel compelled” to offer this treatment, especially given that GWCIM admits that there is no definitive clinical evidence of its effectiveness, particularly considering that, contrary to what GWCIM claims, high dose ascorbate is not without the potential for adverse events. None of this stops GWCIM from recommending high dose vitamin C for the treatment of “a variety of infections as an adjunctive modality.” I fear that GWCIM interprets the science of alternative medicines in the same way it interprets the evidence on vitamin C as a cancer treatment: Through wishful thinking and the most positive spin possible on a body of evidence that does not support their efficacy. Oh, and you can detox, possibly get chelation therapy, and help study reiki at GWCIM, too!

See why I’m depressed? Unfortunately, I’m not done yet.

Et tu, University of Toronto?

I just received an e-mail from a reader yesterday that told the sad tale of yet another domino falling. This time, it’s the University of Toronto. As you might recall, I’ve mentioned UT before on this blog, for example, an autism quackfest held there that UT ultimately disavowed when notified of its true nature. That didn’t stop UT, unfortunately, from having a real quackfest of its own, complete with presentations from a naturopath and homeopath. Yes, the Trojan horse that is quackademic medicine has arrived big time at UT.

And now, apparently, it’s there to stay:

This is why a new academic partnership has formed among our Faculty of Medicine, the Leslie Dan Faculty of Pharmacy and The Scarborough Hospital — a long time community-affiliate of the University of Toronto. The Centre for Integrative Medicine (CIM) will focus on CAM research and education. This will be achieved through an interprofessional approach — led by the Centre’s Director, Professor Lynda Balneaves — that brings together scientists, physicians, pharmacists, nurses, CAM practitioners and others who work in the health care field. Our Faculties of Pharmacy and Medicine will support the scientific research that will ground the Centre’s evidence-based approach, while a Clinical Hub will be established at The Scarborough Hospital’s Birchmount campus to help patients manage their day-to-day health. The result will be a living laboratory that allows us to study ways to safely and effectively integrate evidence-informed CAM therapies, including traditional Chinese medicine, with conventional medical care.

On September 29, our Faculty Council approved CIM’s creation as an EDU-C and on October 17, we will celebrate the official launch of the Centre. Professor Balneaves, working with colleagues across U of T and The Scarborough Hospital, has already been overseeing the first phase of the Centre’s launch, which is focused on consulting and identifying the needs of the community. She is also laying strong foundations for the effective clinical care and research to follow. By spring 2015, the Centre will launch a series of pilot projects designed to address the clinical needs of the TSH community integrated with education and applied clinical research, and it will be ready to announce long-term plans.

“Integrating” traditional Chinese medicine quackery at a new Centre for Integrative Medicine (CIM)? Lovely. Another one bites the dust, although, to be honest, UT was well on its way to becoming a center of quackademia before it announced this.

Integrative medicine advocates strike back

Three years ago, I wrote a post in which I characterized integrative medicine as a “brand, not a specialty.” In it, I described how in the 1990s “alternative medicine” was rebranded as “complementary and alternative medicine” (CAM) and, over the last few years, has been further rebranded as “integrative medicine,” which is frequently portrayed by advocates as the “best of both worlds.” It’s not that kind of “best of both worlds,” but rather this kind, with integrative medicine “assimilating” what should be—and usually is—science-based medicine, such as nutrition, exercise, and natural products into itself and fusing it with a purpose inimical to science-based medicine.

Glenn Sabin apparently doesn’t like such arguments. And, to be fair, there could be counterarguments based on sound reasoning and evidence. Unfortunately, Sabin appears incapable of offering them. Instead, he proclaims that there are “dwindling skeptics,” using what I like to call the logical fallacy known as the bandwagon fallacy. It’s a fallacy Sabin embraces with gusto:

This phenomenon is fueled by growing patient demand and an emerging cadre of integrative-trained clinicians. Patients across the spectrum of conditions and pathologies consistently experience quality outcomes vis-à-vis these services delivered by a wide range of licensed integrative health disciplines.

I like to respond to this sort of argument thusly: You know what else and who else were enormously popular? Yep, Nazi-ism and Hitler. No, I’m not claiming that integrative medicine is in any way like Nazi-ism. It is simply a suitably and intentionally overblown comparison designed to demonstrate the ridiculousness of appeals to popularity like Sabin’s as an argument. Just because something is popular does not mean it is evidence-based or good. It might be, but it also very well might not be. To take another example, half the people in the US do not believe in evolution. Does that mean evolution is not valid science? Of course not. All an appeal to popularity means is that something is popular, and often that popularity in such appeals is exaggerated.

As happy as Sabin is about the seeming “popularity” of integrative medicine, he’s equally ticked off about criticisms that it’s nothing more than a “rebranding” of quackery:

These skeptics darkly describe a continuous ‘rebranding’ of the field: from alternative medicine, to complementary alternative medicine (CAM) to the integrative health and medicine field of today. It’s not a rebranding. It’s an evolution. Some view it more like a revolution. This is about patient-centered health creation and self-efficacy. It’s the natural progression towards greater population health.

That’s right! New Coke wasn’t a rebranding! It was an evolution! Actually, the rationale for recent proposal by that the National Center for Complementary and Alternative Medicine (NCCAM) be renamed the “National Center for Research on Complementary and Integrative Health” sure sounds like a rebranding:

We see the growth of integrative health care within communities across the US, including hospitals, hospices, and military health facilities. With these changes in the research and practice landscape, we believe that our current name no longer accurately reflects our Congressional mandate, which is, in part, to study the integration of these practices as a complement to conventional care.

We also recognize that our current name is not explicit about our research mission, and that it may be misconstrued as advocacy or promotion of unproven practices.

As I pointed out at the time, this is the very same rationale that’s been used since time immemorial (or at least over the last 30 years or so that has seen the rise of CAM and quackademic medicine) every time a name change for “alternative” medicine has been proposed. As I’ve The reason for this continual rebranding of quackery is that words have power.

Sabin is also off base when he writes:

Naysayers declare that nutrition and exercise are neither “alternative” nor “integrative”; that they’ve always been part and parcel of “plain medicine”; that integrative and lifestyle medicine physicians are “coopting conventional medicine!” The truth is that a mere fifty years ago our food was largely unadulterated, grown in fertile soil and much more nutritious. People were generally more active and doctors were teachers (”teacher” actually comes from the Latin word for doctor”). Unfortunately “the teaching” aspect is largely missing today and nutrition, exercise and psycho-social counseling play no central role in the practice of conventional medicine.

Food fifty years ago was unadulterated? What about the concerns about pollution and pesticide use back then that led, in part, to the dawn of the environmental movement and stricter laws and regulations? Wonder Bread was more nutritious? Nutrition, exercise, and psycho-social counseling play “no central role in the practice of conventional medicine”? Whatever Sabin is smoking, I’d want some were it not that I can’t inhale. If psychosocial counseling plays “no central role” in, for instance, oncology, then why is it that the American College of Surgeons Commission on Cancer’s (ACS CoC’s) requirements for cancer program certification now include standards for psychosocial distress screening, survivorship care plans including addressing patients’ psychosocial needs, risk assessment, nutrition services, and physical activity and weight loss programs? Why does the ACS CoC also require education programs regarding cancer awareness and prevention to meet the needs of the community? Why is it, as I mentioned in my NRC paper, that the standard of care for prediabetes and recently diagnosed type II diabetes includes dietary interventions and encouragement of exercise? Sabin is just plain incorrect.

I can’t help but wonder if at some level Sabin knows that we “skeptics” (or, as he calls us, “cynics”) have a point, given that he writes this about us:

Perhaps they’ll refocus their energies on the real perpetuators of medical quackery: those unprincipled charlatans who often rob their patients of life and treasure with ineffective or dangerous products, agents, interventions or ideology in lieu of proven curative and often life-saving standard of care interventions.

One wonders if he means Stanislaw Burzynski. Or perhaps he means treatments like Nicholas Gonzalez’s treatments. Probably not. He does, however, castigate us for this:

I would like to see better attention paid to the contraindications between natural and formulated pharma agents, or a deeper scientific dive into the controversy surrounding antioxidant adjuvant chemotherapy and radiation therapy, and, um, less on whether acupuncture works or if Reiki’s really helpful with reducing stress and anxiety. Clearly, if patients benefit and there are no significant safety concerns, who really cares exactly how they work? (I’m not implying that scientists should stop investigating these matters. I’m emphasizing the primacy of favorable patient outcomes.)

One wonders whether Sabin doesn’t want us paying so much attention to reiki and acupuncture because, deep in his heart, he knows almost as well as skeptics do that they are quackery based on prescientific mystical belief systems. Unfortunately, as has been pointed out in other discussions of reiki quackery at the CCF, University of Arizona, and elsewhere, acupuncture and reiki are some of the most commonly offered alternative medical modality in quackademic medicine. Notice how he also seems to be admitting that these modalities are placebo modalities, asking “ Just because some health creation programs, processes and interventions (especially those based on whole systems) do not perfectly align with the traditional random controlled, double-blinded pharma model of reductionist scientific discovery, does it cancel out the patient’s positive outcome?”

The problem is that the positive outcomes touted have not been demonstrated to be due to these modalities, and, as Steve Novella, Harriet Hall, Mark Crislip, and I have discussed repeatedly, placebo effects are subjective effects, require deception, and are simply being “rebranded” as “self-healing” and the “power of positive thinking.” It’s a narrative being sold by people like Sabin.

Finally, I can’t help but note that Sabin himself has admitted that the name “integrative medicine” is a “rebranding of CAM in an article entitled CAM Is Dead:

Today several integrative centers across the country still contain the words CAM in their name. This is both confusing to health consumers and damaging for these centers’ brand. Most clinics and centers launched during the last decade have evolved with their branding to include today’s more appropriate terminology of “integrative medicine”, “integrative services” or “integrative therapies”.

The bold text is Sabin’s not mine. As I pointed out at the time, Sabin basically admitted that the term “integrative medicine” is about the marketing of quackery. This is not surprising, given that Sabin is the founder of FON Therapeutics, a company that exists for this purpose:

FON is dedicated to positioning integrative health organizations for long term growth while advancing evidence-based integrative medicine as the standard of care.

A leading business development consulting firm, FON specializes in customized solutions—focused on growing patient volume, program and product sales—driven by innovative marketing, messaging and branded storytelling, all rooted in fiscally viable business models that work.

FON offers an e-book by Sabin entitled Grow Your Integrative Medicine Business by Telling Bigger Stories (wow, I wonder if Sabin knows what that sounds like) and a white paper on How to Increase Clinic Utilization of Integrative Medicine Services in 60 Days, while expressing admiration for the Cancer Treatment Centers of America as the 800-pound marketing gorilla. FON is a marketing company, offering all sorts of marketing services to integrative medical centers, pointing out the economic potential of integrative medicine as being projected to reach $50 billion annually. Indeed, in Weeks’ article on the Hyman-CCF partnership, Sabin worries:

Sabin then raised some questions about the intersection of typical functional medicine business practices with the Cleveland Clinic culture. He noted that in Hyman’s private clinic an office visit with the doctor to the Clintons can run pretty steep. It’s $1,500 for 80 minutes with Hyman. Fifty minutes with a nutritionist will set you back $240. Hyman’s clinic does not accept insurance. Hyman’s business model also includes profiting from supplement sales, from which he donates a portion for functional medicine research.

Sabin adds a further question: “How deep will Cleveland Clinic go in terms of embracing a model of comprehensive functional labs looking at biochemical milieu to inform recommendations of well-placed nutraceuticals.” Such lab work-ups can also be quite expensive for patients even as are the bags of natural medicines that are typically part of functional medicine therapeutic regimes.

Although ideology and a misguided view that to become more “holistic” one must embrace quackery seem to be driving the infiltration of quackery into medical academia, we must never forget that there is a clever and sophisticated marketing campaign behind it as well. Does anyone think that the CCF would have embraced Mark Hyman if it didn’t think he can make the hospital significant money? I doubt it, Mark Hyman’s anecdote about how he told the CCF’s Cosgrove that it “probably didn’t want him there” notwithstanding, and I bet Sabin would agree with this point at least.

As much as advocates claim that it’s not just about the money, it’s also about the money.

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IV administration of high dose Vit-C has been shown to essentially have no side effects, unlike chemotherapy drugs and radiation therapy. Since IV Vit-C works just like chemotherapy and radiation therapy by releasing free radicals,

First, it's a bit of a broad brush to equate all chemotherapy drugs with oxidizers. Actually, I'm slightly sure a good number of chemo drugs don't work this way.

I'm also questioning how things generating free radicals in enough quantities to kill cancer cells could have plenty of side effects if they are called drugs, but none if they are called vitamins.
Chemistry is not magic. The same cause will have the same consequences.

The truth is that a mere fifty years ago our food was largely unadulterated, grown in fertile soil and much more nutritious. People were generally more active [...] nutrition, exercise and psycho-social counseling play no central role in the practice of conventional medicine.

And children were more respectful of their elders, yadda yadda.
Golden age fallacy at its finest.

By Helianthus (not verified) on 08 Oct 2014 #permalink

A mere sixty years ago doctors were teachers who were frequently pictured in advertising endorsing cigarettes. Yeah! The good old days!

As Orac says, "words have power." However, methinks Orac misses some things about how this power works.

Quacks would not be rebranding themselves but for the exercise of power on their 'old' names. The terms of those names have become delegitimized one after the other, forcing the move to new rubrics. Alternative medicine --> CAM--> integrative medicine--> functional medicine. These 'rebrandings' would not have occurred in the absence of effective critique of the terms of the older brands.

Now, you can look at this in a couple different ways. Orac seems to see an ever more insidious move towards legitimation of unchanging practices. But there is evidence the practices are changing to keep up with their brandings. 'Alternative medicine" could be anything it damn pleased. But if you call your thing 'Intergrative medicine' you have to face demands that it integrate. if you call your thing 'Functional medicine' you have to face demands that it function.

All in all, the GWIC site scares the bejeebers out of me. But I disagree with Orac on GWIC’s description of Reiki as ‘promoting the natural healing process by providing deep relaxation, abatement of symptoms of distress, or instilling a sense of harmony and balance.’ Orac says, “No, reiki is faith healing.” I say, no Orac, reiki is just hand waving. Dominant understandings of any practice change over time. GWIC is redefining Reiki as NOT faith healing, NOT a magic channeling of healing energy from the universal source. That’s a Good Thing. If enough Influential Forces hopped onto that definitional bandwagon, the Reiki Masters could get their mystical claims chopped off at the knees.

It’s a step closer to Reiki being broadly understood as ‘one available method of relaxation therapy that might or might not work for you as pain management or stress reduction’ which makes no supernatural claims about hand-waving, and may even morph into something that doesn’t involve hand-waving at all — perhaps having the patient lie down as the sound of wind chimes play, while slo-motion cat anime plays on an overhead screen…:-)

In short, the quacks have been forced to adopt words that have the power to limit their potential harm. Can the more outrageous claims of chiro and acu hold up under the rubric of 'functional medicine' under the umbrella of real hospitals? Or will these 'modalities' be reined in to the mostly placebo effect stuff most people use them for anyway? Or rather, do the words they've now adopted have the power to be harnessed in critique of the dangerous claims, and to force the pseudo-science treatments into narrower frames that will deligitmate those practitioners outside the 'quackademic' hospitals still claiming chiro or acu or Reiki can cure actual diseases?

Wow. The value of a GW degree is falling before my eyes.

All in all, the GWIC site scares the bejeebers out of me. But I disagree with Orac on GWIC’s description of Reiki as ‘promoting the natural healing process by providing deep relaxation, abatement of symptoms of distress, or instilling a sense of harmony and balance.’ Orac says, “No, reiki is faith healing.” I say, no Orac, reiki is just hand waving. Dominant understandings of any practice change over time. GWIC is redefining Reiki as NOT faith healing, NOT a magic channeling of healing energy from the universal source. That’s a Good Thing. If enough Influential Forces hopped onto that definitional bandwagon, the Reiki Masters could get their mystical claims chopped off at the knees.

Bullshit. Reiki masters still refer to all the mystical mumbo-jumbo. It's what they believe. It's what reiki is. Academic hospitals such as the Cleveland Clinic, the University of Arizona, and many others still invoke the mystical, magical "channeling of healing energy" nonsense. Don't believe me? Check out the links below.

http://www.sciencebasedmedicine.org/astrology-alchemyesp-and-reiki-one-…

http://www.sciencebasedmedicine.org/reiki-fraudulent-misrepresentation/

http://scienceblogs.com/insolence/2014/03/27/quackademic-medicine-at-an…

GWU is merely excising that nonsense from its promotional materials on its website, likely to disguise the quackery that it is.

A mere sixty years ago doctors were teachers who were frequently pictured [sic] in advertising endorsing cigarettes.

For this I switched off the Plonk-O-Matic?

This phenomenon is fueled by growing patient demand and an emerging cadre of integrative-trained clinicians. Patients across the spectrum of conditions and pathologies consistently experience quality outcomes vis-à-vis these services delivered by a wide range of licensed integrative health disciplines.

A large part of the reason for this "growing patient demand" is the propaganda from promoters of quackademic medicine. It has been shown that if statements are repeated often enough in mass media, many people will believe those statements, whether or not they are true. You know who pioneered that technique, right?

Also, I don't think "quality outcomes" means what Sabin thinks it means.

By Eric Lund (not verified) on 09 Oct 2014 #permalink

Et tu, University of Toronto?

Just another reason why the *ROC hates Toronto.

*Rest of Canada

Note reiki being described as " the placing of hands" and
" the hands remain stationary"-
( also "harmonizing energy" and "non-invasive therapy")

apparently contrived to entirely circumvent the expression:
* laying on of hands* which sounds too biblical.

Also: "a mere fifty years ago, our food was unadulterated, grown in fertile soil and much more nutritious."

Hah! It seems that they have adjusted the partyline ( I am much more familiar with woo-meisters saying '100 years' or the 'turn of the 20th century') which isn't terribly bright of them because many potential customers can recall what they ate 50 years ago
HOWEVER it may perhaps stoke the fires of nostalgia for home-cooked meals, whole grain oven-baked breads and steaming cherry pies created by mothers and grandmothers in days of yore.
Which probably didn't exist across the board-
well alright, it didn't in my families which enjoyed packaged, frozen, canned/ tinned goods and whatever restaurants had to offer. They were ahead of their time.

By Denice Walter (not verified) on 09 Oct 2014 #permalink

HOWEVER it may perhaps stoke the fires of nostalgia for home-cooked meals, whole grain oven-baked breads and steaming cherry pies created by mothers and grandmothers in days of yore.

Nostalgia ain't what it used to be.

The 1950s and early 1960s were very much the era of Wonder Bread. Whole wheat bread existed, but its use by middle-class white families did not gain general acceptance until the 1970s. Flour was generally white flour; I don't recall when whole wheat flour became available in ordinary grocery stores.

I happen to own a cookbook that was published in 1963. The authors of this cookbook seem not to have heard of olive oil. Italian and "Chinese" (the latter being heavily Americanized; I didn't eat real Chinese food until I went away to college in a city with a substantial Chinese population) cuisines were considered edgy. Tea meant Lipton, which Douglas Adams so aptly described as "a substance almost but not quite entirely unlike tea." No, I do not want to go back to that era in US culinary history.

By Eric Lund (not verified) on 09 Oct 2014 #permalink

"dwindling skeptics"
A closer analogy would be the creationists' claim that the theory of evolution has been disproved and the whole house of cards is about to fall. Of course they have been saying that for about 100 years...

Also, 60 years ago Johnny couldn't read and comic books were the cause of juvenile delinquency.

By machintelligence (not verified) on 09 Oct 2014 #permalink

A mere sixty years ago doctors were teachers who were frequently pictured in advertising endorsing cigarettes. Yeah! The good old days!

Is that true? The British Doctor's Study that provided convincing evidence of a link between smoking tobacco and lung cancer was published in 1956. I thought the 'doctors' featured in cigarette advertisements were actors, like the Marlboro cowboys (though some of them really were cowboys, apparently). I have seen the "more doctors smoke Camels" advertisements, but they seem to me to simply show that doctors can get addicted to tobacco just like mere mortals, rather than being a medical endorsement of smoking.

By Krebiozen (not verified) on 09 Oct 2014 #permalink

Just another reason why the *ROC hates Toronto.

To be fair, while Toronto is hated, I never get the feeling that U of T is even disliked. I say this as an alum. Now Queen's on the other hand...

By Dave Ruddell (not verified) on 09 Oct 2014 #permalink

@ Eric Lund:

Right. They want to have it both ways: for it to be far enough back in time so that there isn't a clear memory but close enough so that living people can 'remember' how wonderful food was-
only that like much in the altie repetoire, this meme is concocted of whole cloth, folk tales and clever language in order to lead their thralls where they would have them go: the miraculous but fabulous** past.

Interestingly enough, the TMs and their kin @ AoA, most of whom range in age from 40-60 years, write about how commercial food products have deteriorated when comparing what they grew up with and what is available now. They carry on about how food ( and vaccines) lead to chroniic illness and ASDs in children - as a matter of fact, TMR currently has an e-conference available that focuses upon GMOs and other dastardly plots by the food industry's corporate criminals who are in league with the corporate criminals in pharma etc.

Similarly, PRN and NN spin tales about today's bad food as if most people truly exist on fast food and candy bars.

** in the original sense, as in fabled.

By Denice Walter (not verified) on 09 Oct 2014 #permalink

I always like hearing about these schools offering "Traditional Chinese Medicine" especially when, having lived in China, the Chinese don't really even trust it. When given the option, they always head to a real hospital for real treatment.

"This phenomenon is fueled by growing patient demand and an emerging cadre of integrative-trained clinicians."

Yeah, every 30 years like clockwork, a cadre of integrative-trained clinicians emerges from the ground, chews the leaves off the trees, mates and disappears underground again for 30 more years.

Trouble is, they're resistant to most sprays.

By Dangerous Bacon (not verified) on 09 Oct 2014 #permalink

I always like hearing about these schools offering “Traditional Chinese Medicine” especially when, having lived in China, the Chinese don’t really even trust it. When given the option, they always head to a real hospital for real treatment.

Indeed. Just last weekend, a friend of mine upon hearing that my father was diagnosed with AML a few months ago but is doing very well, now, chirped up with "Did he try Eastern medicine?"

Whereupon I said - a little more sharply than I intended - "No, he decided to use medicine that ACTUALLY WORKS."

Given how much I've been biting my tongue around some folks (If I hear "Gerson therapy" one. more. time.) I think a blowup was overdue.

(The stem cell transplant has settled in nicely and is apparently kicking all the *ss that needs to be kicked. Yay, science!)

Accounts of Chinese traditional medicine started reaching Europe in the 17th Cent. William Wotton, in his "Reflections on Learning....." (1694) reported on it thusly:
"....the Missionary who sent this account ....was afraid it would be thought ridiculous .......which fear of his seems to have been well grounded."
"It would be tedious to dwell any longer upon such Notions as these, ....The Anatomical Figures ...are so very whimsical, that a Man would almost believe the whole to be a banter..."

Wotton, an early manifestation of a skeptic maybe, was a very fair-minded man, and went on to allow that perhaps some Chinese herbal remedies might be efficacious. But I think in the 300 years since he wrote precious little has panned out.

By Peter Dugdale (not verified) on 09 Oct 2014 #permalink

I always like hearing about these schools offering “Traditional Chinese Medicine” especially when, having lived in China, the Chinese don’t really even trust it.

As Orac noted about a year ago, one of the biggest popularizers of so-called traditional Chinese medicine was Mao Zedong himself. He had reasons, specifically that there were not enough doctors in China at the time (early 1950s) who were trained in Western medicine. But Mao always insisted on Western medicine for himself, as he found Chinese medicine implausible.

The quick study of the Chinese language I made before visiting Beijing included a mention of the distinction between Chinese (zhong) and Western (xi) medicine, and how to request the latter if needed (luckily, I never needed to use any of the phrases in that section of the book).

By Eric Lund (not verified) on 09 Oct 2014 #permalink

Apparently, the GW CIM recently hired a new Physician Assistant named Rosina Cabo who will be prescribing bio-identical hormone therapy, nutrition, and supplements.

Also, we learn that the GW CIM is involved in an assortment of quackademic research, including the infamous TACT trial.

TBruce @7 " Just another reason why the *ROC hates Toronto"

Did not know another reason was needed, but as a long term lurker, somehow remember you are out West so: at the University of Alberta ( http://www.care.ualberta.ca/ )

"Healthier children through evidence-based integrative health care.

Complementary and Alternative Research and Education (CARE), launched in 2003 at the Department of Pediatrics at the University of Alberta, is Canada’s first academic pediatric integrative medicine program. Its mission is to generate and disseminate evidence about pediatric complementary and alternative medicine (CAM), to ensure safe and informed use. A clinical assessment program was added in 2006..................." Is further downhill from there.

Although I am not aware of any formal programmes at the University of British Columbia, they are well on their way with a Society on campus; AIMS ( http://www.aims.ubc.ca/ )

Dave Ruddell @12 " never get the feeling that U of T is even disliked. I say this as an alum. Now Queen’s on the other hand…"

Agree for U of T once one gets past the hog smell. Even Michael Ignatieff had to move back to Boston. Queen's is much more refreshing for a better learning experience.

By Ross Miles (not verified) on 09 Oct 2014 #permalink

The public demands these alt med treatments and practitioners because they're fed up with getting 5 minutes with their overwhelmed physicians who no longer have time to develop rapport or a meaningful relationship with their patients.

Since alt med practitioners as a whole cannot (yet) bill insurance for their services, they can charge what the market will bear and spend a whole lot more time listening and pontificating, which results in patients feeling heard and validated. These practitioners tend to have more time to address lifestyle and diet, among other things, however usually end up making overblown claims, recommending wacky, restrictive diets, and prescribing dietary supplements. GAH! This is the mess I often have to clean up. Alkaline diet anyone? Juice Plus? A smorgasbord of herbs? High dose antioxidant therapy? The list goes on and on...

I suspect that patients of concierge or direct pay practices are far more satisfied with their evidence-based medicine than the rest of us. I don't blame the doctors a bit, it's the very broken system that has resulted in creating the market for quack medicine.

The truth is that a mere fifty years ago our food was largely unadulterated,

Think how much purer it must have been one hundred years ago!

By herr doktor bimler (not verified) on 09 Oct 2014 #permalink

Think how much purer it must have been one hundred years ago!

Back then they only used natural non-toxic agricultural chemicals like lead arsenate, whereas 50 years ago they were using organic DDT. These days deadly chemicals like glyphosate are in common use. /sarcasm

By Krebiozen (not verified) on 09 Oct 2014 #permalink

Complementary and Alternative Research and Education (CARE), launched in 2003 at the Department of Pediatrics at the University of Alberta, is Canada’s first academic pediatric integrative medicine program.

Alberta is to Canada as Texas is to the United States. Interesting, and not in a good way, that this analogy holds for alt-med as well as politics and economics.

By Eric Lund (not verified) on 09 Oct 2014 #permalink

Since alt med practitioners as a whole cannot (yet) bill insurance for their services, they can charge what the market will bear and spend a whole lot more time listening and pontificating, which results in patients feeling heard and validated.

If the choice is really between receiving treatment which has actually been shown to be safe and effective and instead being heard and validated while receiving treatments that have either not been shown to be safe or have actually been shown not to be safe and effective, to paraphrase Richard Pryor "I don't know about you but I'm gonna be in the long line".

Kreb:

A mere sixty years ago doctors were teachers who were frequently pictured in advertising endorsing cigarettes. Yeah! The good old days!

That was mean as Sabin-smack, not doctor-smack. Just another indication that the imagined wonderful 'natural' past Sabin conjectures was neither so wonderful or natural.

The most prominent docs&cigs campaign was "Three National Surveys Prove ore Doctors Smoke Camels Than Any Other Cigarette". You can see the history of cig ads at this Stanford Med School site: http://tobacco.stanford.edu/tobacco_main/main.php

Some copy from that site:

One common technique used by the tobacco industry to reassure a worried public was to incorporate images of physicians in their ads. The none-too-subtle message was that if the doctor, with all of his expertise, chose to smoke a particular brand, then it must be safe. Unlike with celebrity and athlete endorsers, the doctors depicted were never specific individuals, because physicians who engaged in advertising would risk losing their license. (It was contrary to accepted medical ethics at the time for doctors to advertise.) Instead, the images always presented an idealized physician - wise, noble, and caring - who enthusiastically partook of the smoking habit. All of the "doctors" in these ads came out of central casting.. Little protest was heard from the medical community or organized medicine, perhaps because the images showed the profession in a highly favorable light. This genre of ads regularly appeared in medical journals such as the Journal of the American Medical Association, an organization which for decades collaborated closely with the industry.

The ads in trade pubs aimed directly at MDs are here:
http://tobacco.stanford.edu/tobacco_main/subtheme.php?token=fm_mt021.php
The first two-subcategories are "science" and "clinical trials."

In short, there's nothing new about free-market profiteers turning to pseudo-science to sell dangerous stuff; and pseudo-science always tries to co-opt real science in seeking to legitimize the sales pitch. However, this is dangerous for the scam-seller, as a backfire is always possible. After 4 decades of pushing cigarettes as Healthy with images of kindly family physicians -- when physicians finally turned on the tobacco industry after the carcinogenic effects were established -- that was Big Blow to Big Tobacco exactly because they had helped build up the Doc's public rep.

Orac:
Of course I believe you, about what your average Reiki Master claims, and that some 'legit' medical faciltiies are embracing the mumbo jumbo. That's not the point. The point is that GWIC's redefinition of Reiki opens a path to defang Reiki of its most noxious mumbo jumbo. It's just an opening, not a sign of teleology that's going to work out by itself.

Between 1880-1980 (roughly speaking) the dominant political order in the U.S. faced a series of challenges in the name of social justice, from the industrial labor movement, the women's movement, the civil rights movement, the anti-war movement. Each of these was met with brute force repression, which in every case proved ineffective. Ultimately, each of these movements was co-opted by the mainstream, and brought into the fold on terms that worked to the advantage of the powers that be. E.g. radical labor sentiment was defused by the trade-unionism of AFL, which led to de-politicized local unions that actually assisted management in maintaining order and discipline on the shop floor. For a more recent example, see Todd Gitlin's The Whole World Is Watching: Mass Media in the Making and Unmaking of the New Left. The common thread: by accomodating and incorporating the least threatening members and demands of each wave of protest, the movements become fractured, and the outsiders become more desperate, their positions amplified to meet the looney images projected by mainstream propaganda, leading ultimately to their social failure. So SDS goes from peaceful protests in the early 60s to Weather Underground bombings in the 70s and then implodes altogether.

It would be nice to see the good guys judo the bad guys just once.

Of course capitalism is 'Bullshit!" But bullshit works. :-) Though you might want to call it something else .

Yeah, every 30 years like clockwork, a cadre of integrative-trained clinicians emerges from the ground, chews the leaves off the trees, mates and disappears underground again for 30 more years.

Are you talking about Cicadids or a crop of Richard Nixons?? As far as I know, the cicadas don't eat anything after they emerge. It's one of the most beautiful cycles to me... I recount my past days and change, brood to brood (both 13 and 17 year-- those days are inscribed in me as if they were laser-etched in crystal) No doubt, people who slave away on worthless and pernicious growing of 'lawns' come along and think they need spraying... these same type people also just must have a streetlight -- They feel unsafe otherwise -- like little indoctrinated children. They have allowed themselves to be trained to just never look up as they won't see anything. And their kids all have sleep disorders and are nearsighted, as well.

--If somebody installs their own or demand it be fixed when it fails, triple bright at that, I say they're too far gone 'derps' and are dangerous to the wellbeing of all others. If it happened to be loud music then I could have them arrested. Go figure.

http://www.youtube.com/watch?v=fzv6JzpCWhI
http://www.youtube.com/watch?v=oqys8lKsu4s

I happen to own a cookbook that was published in 1963. The authors of this cookbook seem not to have heard of olive oil.

The same year that The French Chef premiered, BTW.

I’m also questioning how things generating free radicals in enough quantities to kill cancer cells could have plenty of side effects if they are called drugs, but none if they are called vitamins.

It seems to involve patting your head while rubbing your belly.

About 50 years ago my father's partner used to smoke while consulting his patient's at the surgery. Ah the good old days!

Funny, but not, at the same time.

RE: p53

I've been at Wikischool lots lately and considering N-acetylcysteine (NAC). But:

Because somatic mutations in p53 occur late in tumor progression, antioxidants may accelerate the growth of early tumors or precancerous lesions in high-risk populations such as smokers ... it is important to reiterate that NAC does not cause cancer, it counteracts ROS accumulation caused by p53 and down-regulates p53, which in turn prevents p53-induced apoptosis and promotes autophagy.

and

acetylcysteine was metabolized to S-nitroso-N-acetylcysteine (SNOAC), which increased blood pressure in the lungs and right ventricle of the heart (pulmonary artery hypertension) in mice treated with acetylcysteine.

and

Although N-acetylcysteine prevented liver damage when taken before alcohol, when taken 4 hours after alcohol it actually made liver damage worse in a dose-dependent fashion.

http://en.wikipedia.org/wiki/Acetylcysteine#Adverse_effects

Now, I'm guessing that some xenoprobing may be prudent to make sure there aren't any eighty-foot satellite dishes hiding up there waiting to unfold for that first part??

Annd... I've seen similar concerns over 5-htp and p-5-p and the heart (though, that's mostly from 'fibrosis' I *think*)

Annnd... Is there some commonality/mechanism between the bad outcome of NAC with alcohol and why I now get a raging hangover if a tiny bit over my 'new limit' though drinking much less with the 5-htp/melatonin/5HT workings {past hangovers were rare at 150/day -- and even at the occasional 300}? -- I've seen all the 'good' stated on 5-htp and this 'hangover' encouraging one to drink less but is this hangover indicative of enhanced damage otherwise? (Current EToH ~100ml/day. A six of 4.7s -- All Day IPA because 312 Urban Wheat was 'inconsistent' causing me to look closely at the bottle: B&B'd Baldwinsville, NY and Fort Collins, Co. with all that entails.)

Any SBM thoughts, docs? Or maybe it takes a ND?

* getting that 'sinking' feeling on a long, dark swim

When I was in Med School 40 years ago, we had several instructors that chain smoked. One would lecture on diabetes while smoking one after another for the whole hour. Another would give lab sessions, smoking till our eyes hurt. Another would do autopsies with a butt in his mouth, dropping ash into the thoracic and abdominal cavities. Considering how addictive cigarettes are, it was gratifying to find out that they had all quit smoking a few years later.

@Krebiozen #33

apparently ayahuasca (harmine, actually)

There's a tiny amount of those alkaloids in passionflower (a very weak MAOI) which I'd been incredibly fond of ingesting much these past couple of years until I was unable to tinc up my own this year.

About 50 years ago my father’s partner used to smoke while consulting his patient’s at the surgery. Ah the good old days!

My boss in the biochemistry lab 30-odd years ago smoked a pipe, and would wander around the lab with it lit, which bothered me greatly when I was doing an ether extraction, since diethyl ether is extremely flammable, and explosive when mixed with air.

I only smoked in the lab tea room back then, which seems astonishing now smoking anywhere on hospital grounds is completely banned. We often went to the hospital bar (!) for a pint or two (sometimes more) at lunchtime, and would see a certain eminent surgeon sinking a pint of Abbot Ale to steady his hand before surgery. How times have changed.

By Krebiozen (not verified) on 10 Oct 2014 #permalink

Given that so many advocates of these 'integrative' therapies seem to think the placebo effect is some mystical magical mind-body connection, it's little wonder that the focus will shift from science to advertising. If something works "because you believe it will work," then this is a marketing dream world. Clients are visualized as having invisible little "Lie To Me" placards hanging around their necks.

Indeed, when placebos are the real thing, what would it mean to 'lie?'

Bastyr's undergraduate physics requirement is curious:

1 college-level course
Course must be algebra-based; calculus-based is also accepted.

Your first link led me to discover that apparently ayahuasca (harmine, actually) cures cancer

Harmine seems to do all kinds of stuff.

@ Sastra:

Exactly. I surmise that they think placebos either liberate vital energy to do its healing work or that they're a direct link to the divine source itself.

By Denice Walter (not verified) on 10 Oct 2014 #permalink

^ #40 is of course in the wrong thread.

@Narad - I took literature courses in college that required Calculus as a prerequisite. Just sayin'.

By Mephistopheles… (not verified) on 10 Oct 2014 #permalink

Just need to let you know, "Orac," that you are as blind as a bat. I can't believe you are a surgeon with that type of lack of understanding. I certainly wouldn't want you operating on me. You are intellectual, sure, but somehow just lack the ability to see the big picture. My friend, you have your third eye so calcified shut that it's practically a bone. Not that you have a clue what that means. You really need to stop spreading the idea that NDs are untrained to practice medicine. Have you ever even seen the clinics used to train NDs in states such as WA? Or are you even aware that NDs complete a rigorous scientific medical education, heavy in biochemisty, anatomy and physiology, microbiology, pathology, etc., along with conventionally well-respected subjects such as nutrition and midwifery, as well as herbal chemistry and some Eastern medicine theory and technique, and complete a 2 yr residency in a clinic or in a hospital? Orac, you're a mean-spirited bully who really doesn't prove anything other than that you have a lot of ill-researched opinions. You don't back up your statements with anything other than more of your own unenlightened bias. Either I'm the only person who feels like wasting their time responding to your egotistical, negative, and highly misinformed personal blog that you deem to be the voice of "science," or you don't let anyone with an opinion differing from your own post comments on here. NDs are far from perfect, but they have a PhD, and that is something to respect in ANY field. MDs are also far from perfect and medicine in the United States has a lot of room for improvement. You think it is perfect? I work on both sides of the spectrum, my friend. I have two words for you. "Nosocomial infection." You really need to stop spreading your accusations of "quackery" before someone reports this site for outright slander.

NDs are far from perfect, but they have a PhD, and that is something to respect in ANY field.

No they don't.
And I wouldn't respect them even if they did.

@sheba

Care to point out where you feel where Orac has made mistakes?

Because it sounds like you are making blanket accusations without any proof, and it seems that he hit pretty close to the mark, judging by your remarks.

and complete a 2 yr residency in a clinic or in a hospital

Really?
I checked the licensing requirements for naturopaths in Canada, and it requires 1500 hours of clinical exposure during the 4 years (total) of training. Nothing about a 2 year residency.
MDs in Canada get much more clinical experience during their undergraduate studies for the MD, THEN they require at least 2 more years of residency training before qualifying for primary care medicine.
Also, where would a naturopath do a hospital residency? I have never seen or heard of a naturopath resident in a hospital.
The rest of your little rant appears to be similarly based in reality.

NDs are far from perfect, but they have a PhD

Evidently 'credibility' is not high on Sheba's list of priorities.

By herr doktor bimler (not verified) on 10 Oct 2014 #permalink

I have two words for you. “Nosocomial infection.”

Do NDs have some magical way of preventing infections from spreading in hospitals? Or is it just that they mainly deal with the worried well who don't require hospital treatment? I get irritated by those who criticize conventional medicine for [insert gripe here] when they have no effective alternative.

By Krebiozen (not verified) on 11 Oct 2014 #permalink

Narad,

Harmine seems to do all kinds of stuff.

It even makes people telepathic, when combined with LSD as 'telepathine', if memory serves (not really, of course, but that was the belief, for a while). I wonder if flying carpet tales are linked to the psychedelic effects of harmala alkaloids, since syrian rue is used as a carpet dye in the Middle East.

By Krebiozen (not verified) on 11 Oct 2014 #permalink

Mephistopholes --

I took literature courses in college that required Calculus as a prerequisite. Just sayin’.

Was it a course on Pynchon?

War and Peace also has some calculus-based philosophical speculations, if I recall.

By palindrom (not verified) on 11 Oct 2014 #permalink

In reading (partway) through Sheba's post (@45) I'm struck by how frequently folks in her cadre have never mastered one of the miracles of modern communications: the paragraph break.

By palindrom (not verified) on 11 Oct 2014 #permalink

My friend, you have your third eye so calcified shut that it’s practically a bone. Not that you have a clue what that means.

Honeybunch, you might want to be careful about blundering into places and trying to pull stunts like this while lacking a familiarity with the autdience.

^ "audience"

Oh, this is good:

You really need to stop spreading your accusations of “quackery” before someone reports this site for outright slander [sic].

Is this part of the legal training provided in the naturopathic "Ph.D." program? To whom is "someone" going to "report" it?

NDs are far from perfect, but they have a PhD, and that is something to respect in ANY field.

Amenable to disproof by counterexample, BTW.

Any NDs want to provide a detailed analysis of this?

For the past several weeks an empty store in my neighbourhood was papered over and in the throes of renovation. Finally, a banner went up announcing the imminent opening of an "organic and health food" store. I couldn't give a damn about anything organic, but sometimes these health food stores carry a decent selection of nuts, spices, flours, etc. in bulk.

I walked by this afternoon and they're open. In the window alongside the Rainforest Crisp crackers was an assortment of "detox" crap and a sign stating they had a naturopath on premises available for consultations.

I won't be going in to see if they do indeed sell anything in bulk. I refuse to patronize businesses that are supplement mills and that promote useless, if not dangerous advice from "naturopaths."

At least in my experience those health food store naturopaths limit their advice to pushing products available in the shop and don't delve into serious issues like cancer or Ebola. But who knows? Maybe some of them have private practices and encourage their health food clientele to see them for follow-up in their "clinics" for more elaborate, more expensive and more bogus "treatments." After all, it's hard to diagonose chronic lyme or adrenal dis-orders or fibromyalgia at a card table at the end of the vitamin aisle.

By Woo Fighter (not verified) on 11 Oct 2014 #permalink

Was it a course on Pynchon?
I rate for "The Secret Integration".

you have your third eye so calcified shut that it’s practically a bone.
Fortunately my third nostril is in perfect working order.

By herr doktor bimler (not verified) on 11 Oct 2014 #permalink

Oops...I thought I was posting on the thread Sh*t naturopaths say, part 2: Naturopathic education and science.

By Woo fighter (not verified) on 11 Oct 2014 #permalink

narad - do she shamans shell she-shells?

I took literature courses in college that required Calculus as a prerequisite.

I took one philosophy class that cut to the chase and used operators, but I think that was probably an "or by instructor consent" deal, because I don't recall having seen a familiar face among the smallish class.