Killing Us Softly

by Dr Paul Offit

  After completing one year of a two-year program at the National Institutes of Health, Weil continued to promote his belief that hallucinogenic drugs are good for you. In 1983, he wrote From Chocolate to Morphine: Everything You Need to Know About Mind-Altering Drugs. Weil even has a hallucinogenic mushroom, Psilocybe weilii, named after him. But Weil’s apotheosis came in 1995 with the publication of Spontaneous Healing, in which he claimed that health and illness are “manifestations of good and evil, requiring the help of religion and philosophy to understand and all the techniques of magic to manipulate.” The public ate it up. Weil lectured to packed audiences and appeared frequently on Oprah and Larry King Live. His books became international best sellers, and his face appeared on the cover of Time—twice. Publishers Weekly described Weil as “America’s best-known complementary care physician,” the San Francisco Chronicle as “the guru of alternative medicine,” Time as “Mr. Natural,” and his own books as “America’s most trusted medical expert.” Andrew Weil is one of America’s most famous, most influential alternative healers.

  Another of Mehmet Oz’s “Superstars” is Deepak Chopra. Chopra was born and raised in New Delhi, where he attended the All India Institute of Medical Sciences, and later moved to the United States to complete residencies in internal medicine and endocrinology. As chief of staff at New England Memorial Hospital, Chopra “noticed a growing lack of fulfillment.” He asked himself, “Am I doing all I can for my patients?” So he visited onetime Beatles guru Maharishi Mahesh Yogi, who persuaded Chopra to found the American Association of Ayurvedic Medicine and become the director of the Maharishi Ayurveda Health Center. Ayurvedic medicine, founded in India two thousand years ago, is based on the ancient Greek notion of balancing humors. However, unlike Hippocrates’s four humors, ayurvedic medicine balances three humors, or doshas: wind (vata), choler (pitta), and phlegm (kapha). To determine whether doshas are out of balance, healers take a patient’s pulse.

  Chopra became a national guru on Monday, July 12, 1993, when he appeared on The Oprah Winfrey Show to promote his book Ageless Body, Timeless Mind. Within twenty-four hours he had sold 137,000 copies; by the end of the week it was 400,000.

  In addition to Old Testament and ancient Greek, Chinese, and Indian remedies, Oz also promotes the relatively modern concepts of homeopathy and chiropractic manipulations, both of which represent a kind of devolution in medical thinking.

  Homeopathy was the creation of Samuel Hahnemann, who practiced in Germany and France between 1779 and 1843. Hahnemann was disturbed by the brutality of nineteenth-century medicine, which included bloodletting with leeches, poison-induced vomiting, and skin blistering with acids. He wanted a safer, better way to treat people. His epiphany came in 1790. While ingesting powder from the bark of a cinchona tree, Hahnemann developed a fever. At the time, it was known that cinchona bark, which contained quinine, could treat malaria. Hahnemann believed that because he had fever, and because fever was a symptom of malaria, medicines should induce the same symptoms as the disease. For example, vomiting illnesses should be treated with medicines that cause vomiting. (Homeopathy literally means “similar suffering.”) To be on the safe side, Hahnemann also believed that homeopathic medicines should be diluted to the point that they aren’t there anymore. Although the active ingredient was gone, Hahnemann believed, the final preparation would be influenced by the medicines having once been there.

  Like homeopathy, chiropractic manipulations are also the brainchild of one man: Daniel D. Palmer. Palmer was a mesmerist who used magnets to treat his patients. But in 1895, when a man who had been deaf for seventeen years walked into his office, Palmer tried something else. Believing that deafness was caused by a misaligned spinal column, which he called “subluxation,” Palmer pushed down on the back of the man’s neck, hoping to realign his spine. It worked; the man recovered his hearing immediately. (The event is often referred to as “the crack heard round the world.”) Most miraculous about Palmer’s cure is that the eighth cranial nerve, which conducts nerve impulses from the ear to the brain, doesn’t travel through the neck. Palmer then took the next illogical step, arguing that all diseases were caused by misaligned spines. Because this isn’t true, it shouldn’t be surprising that studies have shown that chiropractic manipulations don’t treat many of the diseases they are claimed to, such as headaches, menstrual pain, colic, asthma, and allergies.

  Although Oz promotes therapies born before scientists had determined what caused diseases and why, he’s enormously popular—for many reasons.

  First, Oz and his Superstars provide an instruction book for something that doesn’t come with instructions: life. Collectively, books written by Oz, Weil, and Chopra tell people exactly what to eat and when to eat it; how to be a friend; how to sustain a loving relationship; how and when to exercise; which shampoos, cleaning fluids, laundry detergents, and baby foods to use; how to prepare meals (including “Dr. Weil’s Favorite Low-Fat Salad Dressing”); and how to treat almost every possible illness. It’s reassuring to know that there’s a right and wrong way to do everything. And because these books are so definitive, so clear about how to handle almost any disease, they inspire a cultlike devotion among their followers. Do it our way and you’ll live longer, love better, and raise happier, healthier children. Given life’s arbitrary, capricious, and unpredictable nature, these books can be quite comforting.

  Another lure of alternative medicine is that it’s personalized. Practitioners of modern medicine can appear callous and insensitive. Patients feel more like a number than a person. That’s where alternative healers come in: they provide individual care, because they care. “Doctors are trapped in this system,” says Andrew Weil. “A ravenously for-profit system.” But Weil isn’t trapped: “I listen to them,” he says. “I take sixty minutes on a first visit.” “My advice for everybody,” says Mehmet Oz, “is to customize therapy for yourself.”

  The promise of ancient wisdom is also appealing. When Mehmet Oz discussed acupuncture on The Dr. Oz Show, he made a rather surprising statement. “It’s the basis of ancient Chinese medicine,” he insisted. Oz was arguing that we should trust ancient medicine because it’s ancient. Today’s culture is filled with this sentiment. For example, in the movie 2012, starring John Cusack and Amanda Peet, the world is coming to an end—something that apparently had been predicted by the Mayan calendar. “All our scientific advances,” laments one scientist, “all our fancy machines—the Mayans saw this coming thousands of years ago.” The writers of 2012 knew their audience. Many people believe that ancient healers and soothsayers, free from confusing modern technologies, possessed a clearer, wiser view of things. “One of the arguments mobilized by alternative medicine practitioners against orthodox medicine is that the latter is constantly changing while alternative medicine has remained unaltered for hundreds, even thousands of years,” wrote Raymond Tallis in Hippocratic Oaths: Medicine and Its Discontents. “The lack of development in 5,000 years can be a good thing only if 5,000 years ago alternative practitioners already knew of entirely satisfactory treatments. If they did, they have been remarkably quiet about them.” Modern medicine is carved by centuries of learning. It continues to evolve because it continues to generate new information. It isn’t fixed in time. But the fluidity of modern medicine can be unsettling. Alternative medicine’s certainty, on the other hand, can be quite reassuring.

  Ironically, while alternative remedies are embraced in the developed world, they’re often rejected in the countries where they originated. In mainland China, for example, where both traditional and modern therapies are available, only 18 percent of the population relies on alternative medicines; in Hong Kong, 14 percent; and in Japan, even less. In China, acupuncture is embraced almost solely by the rural poor. “It’s easy for the well-fed metropolitan with time and money on his hands to talk about dealing with chronic symptoms with ayurvedic medicine or Chinese herbal therapies or ancient African or Native American remedies,” writes John Diamond in Snake Oil and
Other Preoccupations. “But if you go to the countries where those remedies are all they have, you’ll find them crying out for good old Western antibiotics, painkillers, and all the rest of the modern and expensive pharmacopoeia. When the government of South Africa complains that not enough is being done to help the 10 percent of its population which is HIV-positive, it isn’t asking for help with preparing ‘natural’ remedies: it wants AZT.”

  Traditional healers also offer something else. Where modern medicine is spiritless and technological, they argue, alternative medicine is spiritual and meaningful. “The more the universe seems comprehensible,” wrote Steven Weinberg, a Nobel Prize–winning physicist, “the more it seems pointless.” Although modern science offers the prospect of longer lives, it doesn’t offer the prospect of more meaningful lives. Alternative medicine, on the other hand, offers something greater: better health imbued with a deeper sense of purpose. Oz, Weil, and Chopra proffer their remedies with a spirituality that borders on mysticism. “Nothing is more dangerous than science without poetry or technical progress without emotional content,” wrote Houston Stewart Chamberlain, a German philosopher. In a culture that doesn’t understand technology, and is often frightened and disappointed by it, spiritualism is an easy sell.

  Finally, practitioners of alternative medicine appeal to the popular notion that you can manage your own health, that you don’t need doctors to tell you what to do. “Alternative medicine is at the grass roots level,” says Oz. “And because of that, nobody owns it. Alternative medicine empowers us. And if it does work for you, don’t let anybody take it away.” The offer of control in a health-care system where patients feel little or no control is irresistible. “The lure of alternative therapies won’t end,” says Harriet Hall, a former flight surgeon and a regular contributor to Skeptical Inquirer magazine, “until you take the ‘human’ out of human nature.”

  At the heart of our distrust of modern medicine is the notion that we’ve rejected nature at our own peril—that big pharmaceutical companies, by synthesizing products in laboratories, have led us away from the natural products that allow us to live longer. And what could be more natural than vitamins.

  Part II

  THE LURE OF ALL THINGS NATURAL

  2

  The Vitamin Craze: Linus Pauling’s Ironic Legacy

  I gotta tell you, right at the top of my list would be taking vitamins. I know that over the years doctors have said they’re ridiculous and all that. But I started taking my vitamins at an early age. And I take them every day. Every bloody day! So I think that’s number one. For whatever reason, I feel active and pretty good at my age.

  —Regis Philbin

  Everyone loves vitamins. Derived from the Latin word vita, meaning “life,” vitamins are necessary for the conversion of food into energy. Millions of people believe that taking daily vitamins makes them feel better and live longer.

  Thirteen vitamins have been identified. Nine are easily dissolved in water: vitamins B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), B7 (biotin), B9 (folic acid), B12 (cobalamin), and C (ascorbic acid). Four aren’t water-soluble: vitamins A (retinol), D (calciferol), E (tocopherol), and K (phylloquinone). When people don’t get enough vitamins, they suffer diseases such as beriberi, pellagra, scurvy, and rickets (caused by deficiencies of vitamins B1, B3, C, and D, respectively).

  The problem with most vitamins is that they aren’t made inside the body; they’re available only in foods or supplements. So the question isn’t “Do people need vitamins?” They do. The real questions are “How much do they need?” and “Do they get enough in foods?” Nutrition experts and vitamin manufacturers are split on the answers to these questions. Nutrition experts argue that all people need is the recommended daily allowance (RDA), typically found in a routine diet. Industry representatives argue that foods don’t contain enough vitamins and that larger quantities are needed. Fortunately, many excellent studies have now resolved the issue.

  On October 10, 2011, researchers from the University of Minnesota found that women who took supplemental multivitamins died at rates higher than those who didn’t. Two days later, researchers from the Cleveland Clinic found that men who took vitamin E had an increased risk of prostate cancer. “It’s been a tough week for vitamins,” said Carrie Gann of ABC News.

  These findings weren’t new. Seven previous studies had already shown that vitamins increased the risk of cancer and heart disease and shortened lives. Still, in 2012, more than half of all Americans took some form of vitamin supplements. What few people realize, however, is that their fascination with vitamins can be traced back to one man. A man who was so spectacularly right that he won two Nobel Prizes and so spectacularly wrong that he was arguably the world’s greatest quack.

  Linus Pauling was born on February 28, 1901, in Portland, Oregon. He attended Oregon Agricultural College (now Oregon State University), in Corvallis, before entering the California Institute of Technology (Caltech), where he taught for more than forty years.

  In 1931, Pauling published a paper in the Journal of the American Chemical Society titled “The Nature of the Chemical Bond.” Before publication, chemists knew of two types of chemical bonds: ionic, where one atom gives up an electron to another; and covalent, where atoms share electrons. Pauling argued that it wasn’t that simple—electron sharing was somewhere between ionic and covalent. Pauling’s idea revolutionized the field, marrying quantum physics with chemistry. His concept was so revolutionary that when the journal editor received the manuscript, he couldn’t find anyone qualified to review it. When Albert Einstein was asked what he thought of Pauling’s work, he shrugged his shoulders. “It was too complicated for me,” he said. For this single paper, Pauling received the Langmuir Prize as the most outstanding young chemist in the United States, became the youngest person elected to the National Academy of Sciences, was made a full professor at Caltech, and won the Nobel Prize in Chemistry. He was thirty years old.

  In 1949, Pauling published a paper in Science titled “Sickle Cell Anemia, a Molecular Disease.” At the time, scientists knew that hemoglobin (the protein in blood that transports oxygen) crystallized in the veins of people with sickle-cell anemia, causing joint pain, blood clots, and death. But they didn’t know why. Pauling was the first to show that sickle hemoglobin had a slightly different electrical charge—a quality that dramatically affected how the hemoglobin reacted with oxygen. His finding gave birth to the field of molecular biology.

  In 1951, Pauling published a paper in the Proceedings of the National Academy of Sciences titled “The Structure of Proteins.” Scientists knew that proteins were composed of a series of amino acids. Pauling proposed that proteins also had a secondary structure determined by how they folded upon themselves. He called one configuration the alpha helix—later used by James Watson and Francis Crick to explain the structure of DNA.

  In 1961, Pauling collected blood from gorillas, chimpanzees, and monkeys at the San Diego Zoo. He wanted to see whether mutations in hemoglobin could be used as a kind of evolutionary clock. Pauling showed that humans had diverged from gorillas about 11 million years ago, much earlier than scientists had suspected. A colleague later remarked, “At one stroke he united the fields of paleontology, evolutionary biology, and molecular biology.”

  Pauling’s accomplishments weren’t limited to science. Beginning in the 1950s—and for the next forty years—he was the world’s most recognized peace activist. Pauling opposed the internment of Japanese Americans during World War II, declined Robert Oppenheimer’s offer to work on the Manhattan Project, stood up to Senator Joseph McCarthy by refusing a loyalty oath, opposed nuclear proliferation, publicly debated nuclear-arms hawks like Edward Teller, forced the government to admit that nuclear explosions could damage human genes, convinced other Nobel Prize winners to oppose the Vietnam War, and wrote the best-selling book No More War! Pauling’s efforts led to the Nuclear Test Ban Treaty. In 1962, he won the Nobel Peace Prize�
�the first person ever to win two unshared Nobel Prizes.

  In addition to his election to the National Academy of Sciences, two Nobel Prizes, the National Medal of Science, and the Medal for Merit (which was awarded by the president of the United States), Pauling received honorary degrees from Cambridge University, the University of London, and the University of Paris. In 1961, he appeared on the cover of Time magazine’s Men of the Year issue, hailed as one of the greatest scientists who had ever lived.

  Then all the rigor, hard work, and hard thinking that had made Linus Pauling a legend disappeared. In the words of a colleague, his “fall was as great as any classic tragedy.”

  The turning point came in March 1966, when Pauling was sixty-five years old. He had just received the Carl Neuberg Medal. “During a talk in New York City,” recalled Pauling, “I mentioned how much pleasure I took in reading about the discoveries made by scientists in their various investigations of the nature of the world, and stated that I hoped I could live another twenty-five years in order to continue to have this pleasure. On my return to California I received a letter from a biochemist, Irwin Stone, who had been at the talk. He wrote that if I followed his recommendation of taking 3,000 milligrams of vitamin C, I would live not only twenty-five years longer, but probably more.” Stone, who referred to himself as Dr. Stone, had spent two years studying chemistry in college. Later, he received an honorary degree from the Los Angeles College of Chiropractic and a “PhD” from Donsbach University, a non-accredited correspondence school in Southern California.