IT’S ONE THING TO TRY to experience more peace of mind or feel in sync with a divine order. Mixing magical thinking with medical science and physiology, however, can get problematic. A generation after its emergence as a thing hippies did, alternative medicine became ubiquitous and mainstream. As with so many of the phenomena I’ve talked about, it’s driven by nostalgia and anti-Establishment mistrust of experts, has quasi-religious underpinnings, and comes in both happy and unhappy versions.
And has been brought to you by Oprah Winfrey.
In 2004 a very handsome heart surgeon, prominent but not famous, appeared on Oprah to promote a book about alternative medicine. His very name—Dr. Oz!—would be way too over-the-top for a character in a comic novel. After Harvard College, Mehmet Oz earned both an M.D. and an M.B.A. from the University of Pennsylvania, then became a top practitioner and professor of heart surgery at Columbia University and director of NewYork-Presbyterian Hospital’s Cardiovascular Institute. Timing is everything—young Dr. Oz arrived at Columbia right after it set up its Center for Alternative and Complementary Medicine in the 1990s.
Soon he was bringing an “energy healer” into his operating room who placed her hands on patients as he performed surgery, and invited a reporter to watch. According to Dr. Oz, who is married to a Reiki master, such healers have the power to tune in to their scientifically undetectable “energies” and redirect them as necessary while he’s cutting open their hearts.* When The New Yorker’s science reporter Michael Specter told Oz he knew of no evidence that Reiki works, the doctor agreed—“if you are talking purely about data.” In Fantasyland, purely about data is a phrase like mainstream and Establishment and consensus and rational and fact, meaning elitist, narrow, and blind to the disruptive truths. “Medicine is a very religious experience,” Oz told Specter, then added a kicker directly from the relativistic 1960s: “I have my religion and you have yours.”
After that first appearance on Oprah, he proceeded to come on her show five dozen more times, usually wearing surgical scrubs. In 2009 Winfrey’s company launched the daily Dr. Oz show, on which he pushes miracle elixirs, homeopathy, imaginary energies, and psychics who communicate with the dead. He regularly uses the words miracle and magic. A supplement extracted from tamarind “could be the magic ingredient that lets you lose weight without diet and exercise.” Green coffee beans—even though “you may think that magic is make-believe”—are actually a “magic weight-loss cure,” a “miracle pill [that] can burn fat fast. This is very exciting. And it’s breaking news.” He has encouraged viewers to believe that vaccines cause autism and other illnesses—as did Winfrey on her show before him. For a study in the British medical journal BMJ, a team of experienced evidence reviewers analyzed Dr. Oz’s on-air advice—eighty randomly chosen recommendations from 2013. The investigators found legitimate supporting evidence for fewer than half.
The most famous physician in the United States, the man Oprah Winfrey branded as “America’s doctor,” is a dispenser of make-believe.
Let me be clear: not all alternative health beliefs and practices are quackery. Some deserve respect. Physicians can be arrogant hacks. The pharmaceutical business is, naturally, out to maximize profit. Sometimes medical science has been distorted by powerful corporate interests (smoking: cancer). I’m all for healthcare that is focused on prevention, proper diet, exercise, and overall well-being as well as on disease treatment.
I even spend a little time wading in the shallows of the New Age sea. I sometimes swallow capsules of echinacea, an herb American Indians used as medicine—because I read scientific studies that found it may help prevent colds and reduce flu symptoms. I’ve practiced yoga intermittently. And a few years ago I took up daily meditation. There’s now a large scientific literature showing the power of meditation to alter everyday perception in useful ways. “These skills to steer the mind are not magical, otherworldly or transcendental,” the distinguished neuroscientist Christof Koch has written.
Still, I couldn’t read Gilbert Seldes’s 1928 takedown of America’s New Age moment around 1900 and not feel busted. “What then could be the appeal to Americans,” he wrote when he was thirty-five, “of yoga…and the other forms of oriental mysticism?” Maybe it was “that satiety had set in, after all our grasping and possessing, and that we wished to rid ourselves of our encumbrances….Mysticism would then be our escape from the implications of our own materialistic philosophy.” But…not really. Instead, Seldes says, upscale America’s original embrace of yoga and the like “served actually to soothe exasperated nerves” for people who
had not the faintest intention of giving up the world. Yoga was for them a mystic way of renouncing whatever was irritating and preserving whatever was pleasing. It was an elaborate game of pretense by which noisy people went into silence and distracted people imagined that they were concentrating. The glamour of renunciation suffused the picture which they had of themselves. Actually nothing was renounced….One was alone with the mysterious spirit and, breathing in a refined way, one returned to conquer the world.
In any case, the swing of the American pendulum toward unscientific medicine has been extreme and, it now seems likely, permanent. A big problem is that the rubric “complementary and alternative” is so expansive that a thousand bogus cures are legitimized by their popular-front proximity to a hundred useful practices and treatments. Twenty years ago an editorial in The New England Journal of Medicine was spitting mad about the growing respectability of alternative medicine, how it “largely ignores biologic mechanisms” and “disparages modern science,” that it was “time for the scientific community to stop giving alternative medicine a free ride.”
Nice try. Thanks to the coenabling usual suspects—academia, media, government, and business—we are living in two worlds at once, an amazing scientific present and a revived prescientific past, where robotic surgery and 3-D-printed bionic ears coexist with spurious folk remedies.
A century ago Congress passed the Pure Food and Drug Act, the first federal law regulating medicine and essentially outlawing fake patent medicines. It seemed like the definitive defeat of American medical quackery. But it only went underground, then erupted a generation after the tectonic shifts of the late 1960s and ’70s. In 1991 the federal government established an Office of Unconventional Medicine within the National Institutes of Health. That faintly disparaging name was quickly changed to the Office of Alternative Medicine. (Deepak Chopra served as an adviser.) In 1998 it became a full-fledged NIH institute, the National Center for Complementary and Alternative Medicine, then chucked Alternative to become the National Center for Complementary and Integrative Health. This extraordinary apparatus was the work of Senator Tom Harkin, a Democrat, inspired by his belief that bee-pollen pills called Aller Bee-Gone had cured his allergies. The center has disbursed billions of dollars to fund research in homeopathy and long-distance spiritual healing, among other projects.
Harkin, when he retired in 2014, was chair of the Senate Health Committee, and during his last term he was cranky that the institution he’d created seemed way too science- and evidence-based. “One of the purposes of this center,” he complained at a Senate hearing, “was to investigate and validate alternative approaches. Quite frankly, I must say publicly that it has fallen short. I think quite frankly that in this center and in the office previously before it, most of its focus has been on disproving things rather than seeking out and approving.” Harkin also cosponsored a bill in the 1990s, along with two-thirds of the Senate, now a law, that removed supplements—not just vitamins but herbs and other botanicals, hormones, natural whatever—from regulation by the Food and Drug Administration. The author of the law was Orrin Hatch, the Republican senior senator from Utah; not coincidentally, America’s nutritional supplement industry is concentrated in Utah, where Mormons are also concentrated. When federal deregulation was enacted in the 1990s, Americans were buying $9 billion worth of supplements a year; today they spend around $40 billion.
At the University of Arizona, the alternative health superstar Andrew Weil has his own Center for Integrative Medicine at the medical school, with a large faculty that includes a Reiki master/herbal practitioner/aromatherapist. Weil is a Harvard-educated M.D. who provides sensible health advice as well as nonsense about magical energies. Like the Ivy League–trained Oz, he is therefore harder to discredit. Weil’s center and Duke University’s have formed a confederation of woo-friendly divisions of other big-league medical centers, including those at Stanford, half the Ivy League, and dozens more.
Most alternative treatments and cures have failed to be scientifically confirmed. When they sometimes work to relieve pain or anxiety, the science-based people deride it as a mere placebo effect, a secular faith healing. So the believers who want a scientific imprimatur have changed tack and embraced a new, significant rebranding: Okay, fine, it’s a placebo effect—and now placebo medicine and placebo studies are a discipline. They have the imprimatur of Harvard, which started a Program in Placebo Studies and the Therapeutic Encounter. (When I first heard about it, I actually thought someone was kidding me.) Its founder and director has a B.A. in East Asian studies and some kind of sketchy Chinese degree in traditional medicine; he had earned his living as an acupuncturist before Harvard made him a professor of medicine. If placebos can sometimes reduce pain and problems like anxiety, fine. But those are all subjective symptoms, sometimes remediable mentally because they’re experienced mentally.
The problem comes when people jump much further, as they do, imagining and promoting all kinds of nonexistent “mind-body healing effects.” If placebos can calm you down and pep you up and relieve aches, why can’t they actually cure diseases? That’s the bridge too far. The surgical oncologist who edits Science Based Medicine has written that he has “yet to come across a study that provides serious objective evidence that placebos change ‘hard’ objective outcomes, such as survival in cancer.”
Arguments for harnessing placebo power are like arguments that it doesn’t matter if the premises of Mormonism and conversations with Jesus and paranormal experiences are “real.” They’re like the arguments of Donald Trump’s defenders who say it doesn’t matter if he lies as long as what he says feels true. It’s what the author of The Secret explained about her fundamental “law of attraction”—the life-changing fantasy that definitely isn’t a fantasy, but if it is, so what: “The placebo effect is an example of the law of attraction in action. When a patient truly believes the tablet is a cure, he receives what he believes and is cured.”
Maybe most of the millions of Americans who spend billions of dollars a year on homeopathic remedies for their asthma, depression, migraines, allergies, arthritis, or hypertension—six of the ten illnesses most commonly treated—do experience placebo effects and feel better. But some of them are failing to get diagnoses and take medicines that would actually treat their illnesses.
Maybe prompt surgical treatment of Steve Jobs’s relatively curable form of pancreatic cancer would have made him live longer, maybe not. In any case, for most of a year, according to his biographer Walter Isaacson, he resorted to “fruit juices…acupuncture…herbal remedies…treatments he found on the Internet…a psychic,” and so on. “I think that he kind of felt that if you don’t want something to exist,” Isaacson says, “you can have magical thinking” and make it go away. I think of Steve Jobs when I see my neighbors at Whole Foods flipping through the monthly magazine What Doctors Don’t Tell You and the book Herbal Medicine, Healing, and Cancer, by an author whose advanced degree is an M.H.—master herbalist. And browsing the aisles full of homeopathic supplements and elixirs that promise to “build better blood.” And buying expensive gluten-free snacks even though only a minuscule percentage of them have any medical reason to do so.
* Oz’s healer, now practicing in Marin County, California, believes she has the power to “take people back to the origins of their disease and distress in early, hidden family trauma [and] take them down to the level of organ, tissue and cell to see how each responded to the shock and reprogram it.”