Medicine Science Skepticism/critical thinking

The Enemies of Reason, part 2: The Irrational Health Service (with a review)

Thanks to Blake, I now have The Enemies of Reason, Part 2:

My review of this episode is below the fold. I managed to BitTorrent the episode and watch it on my laptop on my flight back from Chicago last night. If you don’t want to be influenced by my opinion before watching, watch the episode first and then see if you agree with my assessment.

Part 2 of Richard DawkinsThe Enemies of Reason, The Irrational Health Service, is, as you might imagine, right up my alley. Moreover, it’s the stronger of the two parts of this documentary in many ways, although I think it continues the theme of the first part quite logically. The theme is that irrational thinking is threatening scientific medicine and endangering health through the propagation of ineffective or at best unproven “remedies.” A lot of people complained about the first part of the series on the basis of their perception that Dawkins was picking on “easy targets” like dowsers. Some of the comments were along the lines of “Dowsers? Does anyone do that anymore?” or “Dowsers? How quaint and British.” Basically, this strain of complaint was that by looking at dowsers in a double-blind fashion and showing that they found water no better than would be predicted by chance alone, big, bad Dawkins was picking on harmless cranks. In one segment in Part 2 in which a particularly loony altie is blathering, Dawkins even addresses this criticism head-on by saying: “I know what you’re thinking: ‘This woman is way out. I expected a serious program about the attack on science, and here’s Richard Dawkins just picking on an easy target.’ But these ideas are not so weird in the irrational world of alternative health. In fact, they’re commonplace.”

The point, of course, is that in the health field such irrational ideas may seem just as harmless as dowsing, but they aren’t. It’s exactly the same irrationality that drives dowsers that also drives alternative medicine. It’s all of a piece.

After an opening montage showing microbes and lauding the accomplishments of scientific medicine and lamenting the proliferation of “superstitious” health practices that either haven’t been tested or don’t work. As Dawkins puts it, “If any remedy is tested under controlled scientific conditions and and proved to be effective, it will cease to be ‘alternative’ and simply become medicine. So-called ‘alternative’ medicine either hasn’t been tested or has failed its tests.”

Just as I’ve been saying all along.

One of the more amazing segments of the show is right at the beginning, where Dawkins visits a healer named Elisis Livingstone who runs the Shambhala Retreat and who blathers on about “deep knowing,” “stepping inside the pearl,” and “traveling in time” to heal–all for a pretty hefty fee. Some of the patients she treats have real and serious diseases, including terminal cancers. The reason this segment really got me is because this woman started spouting nonsense about “Atlanteans” having twelve strands in their DNA and how modern man’s pitiful two-stranded DNA can be bolstered back up to the way it was in ancient times, when the supposedly super race of Atlanteans walked the earth. The part of the segment where she explains to Dawkins how she can achieve this and alter the structure of DNA back to this “twelve-stranded” form is priceless and sounds exactly like a former edition of Your Friday Dose of Woo, in which a similar “healer” claimed that he could “activate your DNA.” (Don’t believe me? Check out this website.)

At least Livingstone was nice enough to transform Dawkins’ DNA into the twelve-stranded form for him. He ought to be much more effective at fighting creationists, alties, and other irrationality now.

Dawkins also takes on the MMR scare, pulling no punches in describing how thin the “evidence” upon which it was based was. I’m only sorry that he didn’t mention Andrew Wakefield by name and use some of Brian Deer’s work describing how Wakefield had serious conflicts of interest or point out the testimony at the Autism Omnibus hearings that showed just how shoddy and sloppy the science and laboratory techniques used by Wakefield were. The addition of such information would have helped to show just how irrational the MMR scare was and how orchestrated. Maybe it’s those British libel laws that are so favorable to the plaintiff, the same ones taken advantage of by David Irving when he sued Deborah Lipstadt, that held the tongue of even Richard Dawkins.

Another excellent segment is where Richard Dawkins takes on homeopathy in general and in particular the British Health Services’ funding of a homeopathic hospital. (That he’s annoyed one homeopath in particular is most amusing.) Indeed, the scene in which Dawkins demonstrates just how much of a dilution a “30C” homeopathic dilution represents is the most visually damning description that I’ve ever seen of how ridiculous the very concept of homeopathy is. (Hint: Picture Richard Dawkins by the sea making dilutions.) It should be shown in every medical school on day one. As for the rest of the segment, I was a little disappointed in how sparse the description of how clinical trials do not support the use of homeopathy was, but I understand that, for a general audience, going into too much detail would have diluted the message and perhaps confused some viewers. Even more effective is how Dawkins describes the financially strapped British National Health Service paying millions of pounds to renovate the Royal Homeopathic Hospital when that same amount of money could have paid the salaries of 500 nurses. Even better is how he hammers on the double standard applied to alternative medicine, describing how a new drug like Herceptin wasn’t approved for coverage right away because the NHS wanted more data on its effectiveness while homeopathy is funded with in essence no scientific scrutiny at all.

One last tidbit is an interview of Deepak Chopra. (Yes, that Deepak Chopra.) Dawkins has the patience of a saint (even though he doesn’t believe in saints) listening to Chopra spew the Chopra-woo. The interview is the culmination of a segment on how alternative medicine practitioners abuse quantum theory. The beauty of the interview (aside from how much of an idiot it makes Chopra look like) is that Dawkins gets Chopra to admit that his invocation of quantum theory is a “metaphor.” Glad to know it’s not science, but then the non-credulous knew that all along.

Dawkins concludes the show with an explanation of how most alternative medicine appears to “work” because of the placebo effect, pointing out how “nice” and caring most of these practitioners are. He even brings out an evolutionary psychologist to try to explain how such attention from other caring human beings might be therapeutic. This is perhaps the most fuzzy part of the documentary, but it is important to explain for a general audience why so many people think they are getting benefits from alternative medicine in the absence of scientific and clinical evidence for it and why testimonials are not adequate evidence that a treatment–any treatment, be it “conventional” or “alternative”–works.

Overall, this documentary is well worth watching. There are always a few nits to pick, but it’s hard to imagine how Dawkins could have done much better in the 1 hour documentary format. Both parts are well worth watching, but the second part is the stronger of the two. The sad thing is, I can’t imagine any American producer doing a documentary like this, and I’m guessing that The Enemies of Reason, if it ever makes it to the U.S. at all, will be shown at late night on PBS stations scattered throughout the U.S. when in reality this nation could use its being shown on prime time on a major network.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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