Friday, December 26, 2008

When reality isn't real enough. Part 1.

First off, quite a day for spreading the not-so-good word, at least in the New York market. I've got this piece, "The Poison of Positive Thinking,"* in The New York Daily News, as well as this one, "The Touch That Doesn't Heal," in The Wall Street Journal. If I do say so myself, I'm particularly proud of the latter, which critiques alternative medicine. Read 'em and weep.

=======================================

Over the past few days, since I blogged about Momma's Boys, I've exchanged a few emails with Newsday TV columnist Verne Gay on the subject of (pseudo) reality shows. We both find it fascinating that today's reality apparently isn't real enough for people
that marketing and ratings imperatives have pushed the very concept of reality TV into something that isn't reality. What began as art attempting to capture life soon became art imitating art capturing life, then art imitating an embellished vision of life as life might look if it had been captured at only its most compelling moments, and then...well, who the hell even knows where we are now.

The more I think abo
ut it, the more I realize that this topic extends well beyond revenue-generating initiatives in which Ryan Seacrest has a Machavellian hand. I'm reminded of how few feathers were ruffled this past spring after famed photo retoucher Pascal Dangin, who is much in demand for making models look like what we expect our models to look like (in pictures anyway), casually told The New Yorker that he'd worked even on Dove Beauty Products' celebrated "real women" campaign, retouching the advertiser's "real women" to look not quite so...real. "Do you know how much retouching was on that?" he asked writer Lauren Collins at one point in the interview. (Though The New Yorker used a question mark at the end of that sentence, I rather picture an exclamation point.)

For the record, Dove categorically denied that its models had been airbrushed or otherwise modified in any meaningful way, and Dangin himself later backed away from his original remarks. That's not the point here. The point is that the mere allegation should've touched off a firestorm; there should've been women, angry mothers of impressionable teenage daughters who are compulsively dieting at great detriment to their health, marching in the streets, descending on Dove's corporate headquarters to demand an explanation. In fact the story broke and died in a matter of days.
(Do you even recall hearing about it? 'Nuff said.) Especially in sophisticate circles, which tend to set the public agenda (or at least determine which themes and variations get the spotlight), the whole affair was greeted with shrugs and yawns. This tells me that many of us have become so jaded that we don't expect reality to be real anymore, even when we're ostensibly rejoicing at the very idea that real women can be (and are) beautifuland we build an elaborate ad campaign around that theme.... In my mind's eye, I see some frazzled art director or account exec attached to the Dove campaign standing there biting his tongue or his index finger as he reviews the contact sheets for the photo sessions, trying to get through it all without making/demanding changes...but in the end he simply can't handle it. Can you just make them look a little bit better? he finally says in a soft voice... Or a she finally says it, which is sadder still.

More next time, including how this connects up to SHAMland.

* Not my title, and a bit overstated, methinks. It was never my thesis that positive thinking is "poison," per se. I just have a major gripe with the way the concept is packaged for popular consumption.

51 comments:

Chad Hogg said...

Ironically, the article on Pascal Dangin featured this cartoon inserted: http://www.cartoonbank.com/product_details.asp?sid=52427&did=4&sitetype=1&affiliate=ny-randomcart

At least someone else in that industry sees the natural consequence of the SHAM-ery.

Dimension Skipper said...

I came across this piece a while back, but was unable to find an opportune time to post the link. The time and topic probably still isn't perfect, but better, so here it is...

Beware the destructive nature of greed
By A.C. Grayling (Nov. 5th for NewScientist)

It might not be quite what you'd expect (although it basically is for the most part). The author kind of makes the same point you do, Steve, about unchecked exuberance being a danger, but also extends that thinking to the concept of global warming. For your convenience I quote here the concluding paragraphs which features the environmental extension of the principle:

. . . .

The serious point here is that the financial meltdown is a classic display of non-rational behaviour. Greed prompted dangerous risk-taking, and was followed by panic that made stock markets plunge wildly, causing a number of blue chip companies to collapse or be nationalised. Unless serious steps are taken to avoid a repetition, as soon as everything stabilises the sequence will restart. The profit motive appears to trump all other motives, by any legal or near-legal means available. It will reassert itself and eventually get out of hand again.

It is important to recognise this because there are is another arena where the profit motive wreaks even worse havoc and is poised to wreak yet more: the natural environment. As the ice caps melt, they increase accessibility to a host of natural resources, not least oil and gas, and open up new and quicker sea routes. This will trigger a rapid increase in exploitation of polar regions unless international agreements to prevent it are brokered.

The global financial meltdown and the melting of the polar caps both emphatically teach the same thing: if there is one thing we cannot afford, it is unbridled profiteering.
_____________________

On the subject of "airbrushing" and similar advertising tricks...

For some reason your post reminds me that Burger King has always bugged me because, in their ads and on their menu board images, they always show their sandwiches with these big whole actually leafy leaves of the greenest lettuce you'd ever hope to encounter this side of Eden. And yet, the sandwiches I get always have this shredded/minced lettuce, very little of it actually closer to green than white. If an alien were to order a sandwich and didn't know what lettuce looked like in it's straight-out-of-the-field form, he wouldn't have a clue allowing him to form any association betweeen what was presented as what-you-SHOULD-get (before) vs. the what-you-ACTUALLY-get (after) image.

The same goes for tomato slices to re the ripeness, but that's true of all the fast food joints. And I understand that not ever tomato slice can be perfectly red-ripe, especially when out of season for whole regions. The lettuce thing, though... they completely alter the form from the presented image to the offered product.

Perhaps it's just my own pet peeve.
_____________________

I also seem to recall (way, way back when and I can't remember specifics of where or when, though it could have been NPR) that often advertisements featuring food items may actually include components that aren't even edible, but simply LOOK as good or better than the actual food component. I think this might typically occur with sauces, gravies, dressings, and things liquid-y. The explanation I seem to recall involved the issue of having to keep food looking good and fresh over a period of many hours of set preparation and shooting under hot lights. I don't mind that so much as long as the visual resemblance does not wildly differ from the actual product.

It's sort of like how in movies they can make almost anything look super-real anymore. I know that animals can't talk, but if they can make it seem real that's terrific. The difference is that the illusion is essential to telling the story and not selling me a physical product. I'm watching the story because on some level I WANT to be deceived into believing incredible things for a couple hours. But when being sold a product, I want to have more realistic expectations presented on an honest foundational basis.
_____________________

Finally, didja ever notice how this time of year so many stores offer "the perfect gift"? And didja also ever notice how those "perfect" gifts just happen to be among the more expensive items a particular store sells?

Either that or it's... The all-in-one Ronco Turnip Twaddler—now digital!!! The perfect gift for Aunt Mabel!
_____________________

I'm just sayin'...

Happy personal preference of holiday(s)—including none at all, merely a general good day wish—to all SHAMblogians out there...

;-)

Dimension Skipper said...

On the subject of CAM, my Mother had various health issues for several years before passing away five years ago. Among the various doctors she consulted along the way was one prominent local doctor specializing in alternative treatments (chelation therapy was the biggie, I think and, no, I'm not going to mention the doctor's name or his practice).

Of course, she never actually got to see HIM, only associates. And they required her to talk to a staff nutiritionist before doing anything. Which was fine.

The staff nutritionist was a guy who looked as if he might still be a teenager. This guy pricked her finger and put a drop of her blood under a microscope and showed us how the cells were very lethargic. (Understand, I'm not providing exact quotes and sequences here, but am trying to convey the gist of the experience as best I remember now years later.) He said that in a normal healthy person those cells should be energetic, just bouncing around for a while, not sluggish. The kicker for me was when he asked us something to effect of ...that makes sense, doesn't it?

It was obvious (to me) that we were supposed to just nod our heads and go along without thinking about it. Not me. I immediately spoke up and countered that I wasn't saying he was wrong necessarily, but I didn't just accept it as "The Truth" either.

I explained that to my way of thinking, he just took that blood out of her body. It's no longer being pumped along through her veins, encountering currents and bend-y spots, swirling around in various eddies here and there. No longer being propelled, her blood was now just sitting there on a glass slide. So to me, it seemed more natural that it might actually look "sluggish" the way it did.

I didn't just say I thought he was full of it, but I let him know I wasn't just going to take his word for it and be magically convinced. Since he'd already said that a healthy person's blood should look more energetic, I offered to let him "do me" as a comparison. I was giving him the opportunity to really convince me. He refused. I also said he could "do himself" and show us. Again, he refused.

To this day I still can't definitively state that he was wrong, but I really have no personal doubt that his spiel fell in the realm of quackery. Mom tried a couple things the associate doctor recommended and saw her a couple times more maybe, but that was it. I wouldn't have stopped her if she wanted to continue, but I think she saw it pretty much as I did when the guy wouldn't run the simple comparison test. And the associate doctor's simple treatment regimen (NOT chelation or anything major or invasive) didn't pan out either.

As for the refusal to duplicate the test I think the guy gave some excuse of legal liability or cost of materials for not doing the test on anyone else, but I was willing to sign a waiver and/or pay for the glass slide. The test was very minimal.

I just hate when doctors (or anybody) spout some mumbo-jumbo and ask if you see the crystal clarity of the reasoning, just expecting you to shut your brain off and go along nodding your head yes, yes, yes...

Elizabeth said...

The all-in-one Ronco Turnip Twaddler—now digital!!!

That's what I got for Christmas! (Maybe it really was for Aunt Mabel, now that I think about it...)

DS, when it comes to food ads, the "food" in them is rarely edible. And it's not just the sauces, the whole thing is concocted of various strange substances that have nothing to do with food, but they photograph well. Look, for example, at those mouth-watering fresh strawberry pies from Baker's Square: I have yet to buy one that would ever look the way its picture promises.

Steve, remember our exchange about Martha Stewart's extravagant holiday recipes this year? You reminded me that that's what people want -- the fantasy and the promise of a better life -- especially when the reality is tough. Same goes for Dove ads, or any ads, for that matter. Reality as is does not sell -- it's usually misshapen and discolored, wrinkled here and there, has crooked teeth and cellulite. The advertised product has to offer a promise of a better, improved reality -- otherwise who'd wanna buy it? So it has to be associated with picture perfect images of whatever that reality may be. Speaking of which, how about the Viagra/etc. commercials? Who are the happy, care-free couples who lounge around waiting for "when the moment is right"? Whose life is it, anyway?

But the fake story of Megan from Momma's Boys, that is a new and, as the Anon yesterday noted, shocking level of deception.

Chad Hogg said...

This is actually a response to the CAM article. I saw an advertisement earlier this afternoon for Cancer Treatment Centers of America. A bit of research reveals that they practice both traditional, evidence-based medicine and CAM. Their advertisement is based on the idea that people who are "fighters" will beat cancer with the right mindset and the support that they (unlike your local doctor) will provide. Patients need to be the decision-maker when it comes to whether to attempt aggressive treatment or simply manage pain, but that needs to be based on an accurate representation of their options, with the risks, benefits, and likely outcome of all of them. Telling people they can beat it if they just try hard enough is no kindness.

Steve Salerno said...

Telling people they can beat it if they just try hard enough is no kindness.

Hence, my dubious post some time back about Lynn Redgrave's "I'm not going to die of cancer" TV spots...for which I took a lot of heat, btw, even from many of our regulars here.

Elizabeth said...

Chadd, Cancer Treatment Centers of America are notorious for their pastel and misty-eyed ads, contrasting their wonderful patient care with the "inhumane" treatment one gets in traditional hospital settings. I do not know anything about CTCA quality of care, etc., but those sugary ads make me suspicious on their own. Very in-your-face too-good-to-be-true.

Elizabeth said...

While on the subject of airbrushing, have you seen the Vogue cover with Kate Winslet from a month ago? It sparked a mini-outrage for its creative adjustments that made Kate W. look almost unrecognizable. Both Kate and Vogue denied any airbrushing.

You be the judge: http://tinyurl.com/6tgmnw

This is not the first time Vogue and Kate have been caught red-handed in this area -- the January 2007 cover, featuring an improved version of Kate, caused a similar stink.

Anonymous said...

I have a friend who worked on the Dove ads for "real women" and they were airbrushed! But who isn't? Everyone these days is airbrushed and photo shopped within an inch of his or her life. Even Jessica Alba was photoshopped and airbrushed for her new Campari ads. Playboy made paintings out of their "bunnies" too.

Steve Salerno said...

NOTE: For some reason, I've received a number of submitted comments today from people who claim to have inside info in a variety of areas--a la Anon 3:42. I've actually rejected several of them. My general policy is to be very skeptical of such comments, especially when people are veering off into legally sensitive matters. Though bloggers recently have been afforded greater protection from liability for false/reckless comments made by visitors, I urge readers to take all anonymous comments--and for that matter, even those attributed by name--with a grain of salt.

For the record, this blog assumes no responsibility for the "factual" material put forward by anonymous posters, especially when it's done in a hearsay format (e.g. "I have a friend who...")

Noadi said...

As someone who does a good deal of photo editing for my business (I'm a sole proprietor I don't have anyone to do product photos for me) I can tell you that everything gets touched up even if it's just adjusting the lighting.

I'd expect even the dove campaign to touch up the photos because it's easier than to try and get the perfect shot. At the least I'd say those women have their skin tones evened out, most women are going to have splotchy areas especially if the studio wasn't really warm. Photo retouching has gone overboard since digital airbrushing became available but it's been going on since the invention of photography. Even retouched I give the dove campaign credit for showing a wider variety of body types than the media typically does. I wish it would become the norm but I'm not holding my breath.

Elizabeth said...

Steve, I like both of your articles, actually "The Poison" a bit more.

But, wow -- "DNA Activation Healing Project"? Does anyone buy this?

RevRon's Rants said...

Steve, In all fairness, isn't the media merely doing what each of us do - selectively remember or forget details about past events and people? We look backward with nostalgic reverence to relationships past, to memorable times in our lives, and even to our own most blatant lapses in logic, conveniently "airbrushing" out the details we'd rather forget, whilst embellishing those we cherish. I'm not saying it's a good thing to do, or the logical thing to do... but we *do* it, nonetheless. And in that light, isn't the trend toward "reality" programming no less "real" than our own lives? And do we serve ourselves well by looking to commercial entertainment programming for anything resembling relevant truth in our lives?

verif word: flawed

Steve Salerno said...

Ron, I think there's a difference between (a) "selectively remembering or forgetting" details, and (b) fabricating characters out of whole cloth--especially when it's being done for the specific purpose of manipulating viewers. Cinema verite should be cinema verite. Otherwise why call it "reality TV"? Why not just leave it at...TV? Or look at it this way: if Momma's Boys had been presented as just another sitcom, and the producers were honest about the fact, would nearly as many of us watch? Aren't we watching (those of us who do) because we think it's "real, raw, unscripted, etc."?

And incidentally, someone sent me a very profane (and thus unusable) comment in which it was suggested that Megan had duped Seacrest et al, thus it was "totally bogus" of me to blame the show. I have any number of grounds for doubting that--but first and foremost, consider that the teasers for the very next show depict the stage hands dragging enormous trunks full of the girls' "background checks" into the room for the mothers to peruse, so they can then confront the girls on their (presumably sordid) pasts. Thus it's clear that Seacrest had all of this info available from the start. He knew damned well who was who. Or who wasn't who, as the case may be.

RevRon's Rants said...

Point taken, Steve. But it still leaves us to ask ourselves my final question: do we serve ourselves well by looking to commercial entertainment programming for anything resembling relevant truth in our lives? Or by doing so, are we exhibiting the same kind of gullibility that catapulted The Secret to success, and that keeps the self-described "stars" of that absurd production busy coming up with their infinite stream of products that promise the "real" secret?

Anonymous said...

'Aren't we watching (those of us who do) because we think it's "real, raw, unscripted, etc."?'

Actually, no. All of us watch TV, reality or not, as a relief, distraction from the "real, raw unscripted" process of our own lives.
And each of us construct our personalities, singular or multiple from whole cloth, some of us are aware of doing so, most not.

Tom L. said...

I'm a doctor (internist) who doesn't use any CAM in my practice and who recommends CAM only to patients with psychosomatic illnesses and those with chronic ailments who have exhausted the mainstream treatments without satisfactory results ("Your back Xray shows the garden variety degenerative arthritis and degenerative disc disease, Mrs Jones. If your anti-inflammatory meds and physical therapy aren't helping, you might try some acupuncture, or trigger point injections, or chiropractic adjustments.").

So you can know that I agree with your article. It is one more reminder of the ingrained irrationality which no human has ever been able or may ever be able to shed. Not to mention the varying degrees but universal presence of ignorance we all operate under.

Some of your commenters helped to underline your theme. For example Louis's rambling contradictions (in wsj online comments). I was going to point out my take on the irrationality and ignorance of his comment until I read though the whole thing and was overwhelmed by the number of irrational/ignorant points.

I read articles like yours and say, "Yes, yes," and then I throw up my hands in dismay and frustration that despite the appearance of the essay in a publication of wide circulation, the numbers who read it, let alone those who are actually persuaded by it, are too infinitesimally small to have any impact on society. Linus Pauling's theory of prevention of the common cold with pharmacological doses of vitamin C was solidly disproved more than twenty years ago, yet patient after patient who walks into my office continues to take it. I have long since given up on trying to educate them that it does no good. Now I only ask how much they take, and advise them to keep below 1000 mg per day in order to avoid the potential side effect of oxalate kidney stones.

After I read articles such as yours, I fantasize about being inspired with some miraculous means of dispelling the ignorance and irrationality of one or another of society's misconceptions. I know that if one felt it were important enough, one could go on a one-man campaign to convince the world about an issue that he has a rational knowledge of. One successful real life example that comes to mind is Phyllis Schlafly's single-minded campaign to defeat the equal rights amendment.

But then the necessities of daily life intervene. And I settle for venting.

Elizabeth said...

In [some] defense of herbology (but, as you may remember, none of it is news to Poles :):

Candy Canes Fight Germs, Settle Stomachs

Jennifer Viegas, Discovery News

Dec. 24, 2008 -- New studies on peppermint, the key flavoring in traditional candy canes, reveal the herb may do everything from kill germs to treat digestive troubles.

(...)

Peppermint oil, found in most candy canes, also appears to have health benefits. A recent British Medical Journal study, led by McMaster University researcher Alex Ford, concludes that peppermint oil should be the first line of defense against irritable bowel syndrome, a condition characterized by abdominal pain and irregular bowels that affects between 5 to 20 percent of the population.


Full text:
http://tinyurl.com/9ekqed

DavidEmerson said...

Steve- regarding your article titled "the touch that doesn't heal," several facts-
1) 80% of all clinical trials are conducted by Pharmaceutical companies who have little to gain by testing complimentary therapies like acupuncture. Therefore "evidence-based" findings will never never be found for cam therapies.
2) Andrew Weil is a medical doctor not a self-help guru.
3) I am a 15 year survivor of an incurable blood cancer-multiple myeloma. After 3 years of conventional therapies like VAD, cytoxan and a peripheral blood stem cell transplant by cancer returned and my oncologist told me that "nothing more could be done for me." Yes, I represent "anecdotal" evidence. But I am alive no thanks to conventional oncology. I owe my life to nonconventional therapies- to read more about my case go to
http://beating-myeloma.org/David-Emerson-Story
David Emerson
http://beating-myeloma.org/

Steve Salerno said...

David, I am glad you are well. I have said all along, if something works for someone, or appears to work, that is the bottom line for that individual. The same applies in self-help, btw. Incidentally, I have some personal knowledge of Andrew Weil, MD, as a result of experiences that date back to my short stay at Rodale and our corporate overtures to Weil, whom we hoped would become one of our "star" authors. But I'll keep my counsel on that.

What I object to--and massively so--is when these approaches are sold as universal panaceas, which too often tends to be the case. An opportunistic self-styled "healer," working from results such as yours (which may or may not have scientific validity), will generalize your case into a Universal Truth. I know people who swear by remote prayer. And I know people who claim that chelation therapy freed them from coronary artery disease. The great (now-retired) hitter, Wade Boggs, used to eat chicken every day before a game because he claimed that he'd had success with that tactic and didn't want to break the pattern. I repeat: You can find evidence for almost anything. If these approaches are valid, how come NCCAM has had such a hard time documenting that validity despite 16 years of cheerleading for CAM, and over $1 billion invested?

Further, the fact that it's hard to get funding for these studies doesn't mean we should therefore say, "Oh, well then, never mind the studies, we'll just go on faith." Does it?

Elizabeth said...

Well, what do you know... Here I am, banging my drum on herbs and Poles, and David chimes in with his story (and the Polish doc, Dr. Burzynski).

Thanks for sharing that, David. I'm happy to hear that you are doing well.

Dr. Burzynski's story is quite interesting, Steve, check it out if you have time.

RevRon's Rants said...

"Further, the fact that it's hard to get funding for these studies doesn't mean we should therefore say, "Oh, well then, never mind the studies, we'll just go on faith." Does it?"

Of course not, but neither should we be so naive as to accept as gospel the results of studies funded - and even structured and interpreted - by parties who have a vested interest in a specific outcome. Perhaps by being neither so quick to dismiss nor to embrace things about which we have little actual knowledge, we may hope to actually learn things we find useful. An open mind and common sense are not, after all, mutually exclusive.

Elizabeth said...

Further, the fact that it's hard to get funding for these studies doesn't mean we should therefore say, "Oh, well then, never mind the studies, we'll just go on faith." Does it?

No, it doesn't, Steve, of course you're right.

OK, I'm not David, but I'll pipe in here again, risking a massive deja vu for all regular SHAMbloggers. First, however, let me state that I do not have a horse in this race: I have never patronized a so-called alternative healer (and it's not for lack of opportunities); but I did grow up in a country where herbs are part of mainstream medicine, along with state-of-the-art medical technology.

I agree with Lundberg's statement that "There's no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data."

But I would like to stress the importance of evidence-based medicine over its prejudice-based kind. Let me 'splain: In the US, you have two (strange to a relative outsider) extremes in approach to the so-called alternative medicine, and they are closely related: there is a proliferation of outlandish pseudo-therapies on the one hand, and, on the other, a knee-jerk rejection by certain doctors and opinion-makers of anything that smacks of the "alternative" label (even if it may be anything but "alternative" in most societies, such as herbs, for example) without proper consideration given to available empirical evidence. Both approaches are ignorant and ultimately harmful to the public and the profession.* Of course it's scientifically unsound to make outlandish claims without a shred of evidence to support them, but it is also scientifically unsound to dismiss off-hand any existing evidence of the effectiveness of the so-called alternative treatments just because it does not conform to the critics' ideas of what "real" medicine is. (I also argued here before that the for-profit set-up of the American health care system encourages and deepens this hostile dichotomy, to the detriment of progress in medicine and well-being of the public. I believe it is an important factor slowing down our march toward the one medicine proposed by Lundberg, which is based on *all* available evidence and supported by scientific data.)

*The tumultuous professional saga of Dr. Burzynski a prime example.

P.S. As to prayer and its healing powers, there some evidence showing that it may actually "harm" (or harm, without quotes) those sick individuals who are being prayed for: http://tinyurl.com/77ssus

Dimension Skipper said...

First off, David, I too sincerely echo the sentiment that I am glad you apparently found a treatment that worked for you and are around to be able to comment here.

Second, I make no personal judgment one way or the other of Dr. Burzynski, his practice, or his treatment(s). I am not a doctor, nor do I even have any sort of medical training. I can only read with a layman's perspective what I Google up.

And in googling antineoplastons the top item that comes up is this QuackWatch page. I will not attempt to convey any of the information presented there or to vouch for its accuracy. I encourage folks to read it for themselves and glean from it what you will.

There are also these Wikipedia pages for antineoplastons and Dr. Burzynski.

Finally, here's a relevant introductory antineoplastons PDQ® page at cancer.gov (first of several pages in sequence). I see links to info about CAM in the lefthand links to other pages of the same document. I didn't click them yet to see what they have to say.

That first page led me to same-site links for Questions and Answers About Antineoplastons (the second page of the doc) as well as an antineoplastons PDQ® which also appears to be the first page of a multipage document.

Honestly I don't have time to read much of any of them and probably wouldn't be able to make much sense of them if I read them word for word. However, others around here may be able to check them out better than I can. From what little I did see I have no idea if they're positive, negative, or neutral.

And of course as always there's loads of other stuff you can Google up.

Personally, since a cousin/good friend of mine was diagnosed in September with inoperable pancreatic cancer (he's since finished chemo and radiation and now all he can do is wait and see how effective they were), I would LOVE to be able to google up some promising treatment, mainstream OR alternative, that could potentially help him stick around for longer than the few months (maybe a year) the doctors say he probably has left.

Steve Salerno said...

I think at this point I'll let the Journal piece, as well as the relevant chapter in my book, speak for themselves. Of course, further and/or dissenting comment from those who wish to weigh in is always welcome.

Cal said...

Jennifer Aniston admitted on "The View" that her recent "nude" photo on the cover of GQ magazine was Photoshopped, in response to a question from Barbara Walters.

Elizabeth said...

DSkipper, I'm sorry to hear about your cousin. I hope his chemo and radiation will bring positive results.

Dimension Skipper said...

Thanks, Elizabeth!

Steve Salerno said...

Here's a link to what appears to be an "official response" to my Journal piece from Chopra, Weil et al.

http://tiny.cc/3lnMJ

Regulars may find it interesting.

(I'm also posting this under my most recent blog.)

Dimension Skipper said...

I am in the process of reading their response, Steve, and I just reached this paragraph:
________________

Nor does it sustain a doctor's sworn duty to "first do no harm." Abundant evidence uncovers high-tech medicine, with its powerful drugs, as a major, possibly the leading, cause of death in this country. The National Academy's data attributes 100,000 deaths per year to physicians' errors, added to well over 100,000 deaths due to severe drug interactions and another 100,000 fatalities from hospital-based-infections. (For a detailed analysis, see Death By Medicine, by Gary S. Null, et al.)
________________

The bold highlighting is mine because that name triggered a memory of having had reason to google him before at some point. Here's a QuackWatch page re Mr. Null (and I can't help but notice that even the rebuttal article paragraph I cite does not refer to him as "Dr."): A Critical Look at Gary Null's Activities and Credentials, by Stephen Barrett, M.D., and apparently last updated on March 13, 2005.

I realize you surely don't want to get into the position of having to referee a battle of credentials and/or accusations (for legal and other reasons), so I'll just let the link about Null's credentials, the rebuttal article to your WSJ piece, and indeed your original WSJ article itself speak for themselves. And everyone else is of course free to check out all three (as well as anything else they can Google up) and form their very own opinions as I am still in the process of doing myself. (I just was compelled to point out that particular associative reaction I had at that point, merely in a "for what it's worth" kind of way.)

In a minor SHAMblog-specific aside I'll point out that if one skips to the bottom of the Null QuackWatch page there is a yellow box containing a "reader response" to the QW page in which the person states "GARY NULL IS GOD !" So I guess now it's up to Gary Null and Elizabeth to duke it out for the title of Supreme Being. I for one won't be stepping into the middle of that fracas. ;-)

Now I'll just go back to reading the rest of the response from Drs. Chopra, Weil, and Roy...

Dimension Skipper said...

The following is of course just my own two-bit opinion, mine and mine alone...

So now having finished reading the official rebuttal piece and finding your own personal re-rebuttal comment posted at the end of their rebuttal, Steve, I will say that I was thinking many of the same things you point out there. You obviously do not need my help in defending either your WSJ article or your views as outlined therein.

One thing I would perhaps add is that I believe some of the so-called cited "failures" of evidence-based medicine were never widely accepted treatments, but instead parts of studies that at least were promising enough to reach the human trials stage. (I admit I could very easily be wrong about that as I'm not a medical expert/practitioner or even a mere dabbler in medical information. I'm sort of the Sergeant Schultz of medicine, but not nearly as high ranking.)

There is obviously a part of mainstream medicine that involves clinical trials of medicines and treatments based on emerging theory and possible evidence (which may be subject to interpretation, learned interpretation to be sure, but interpretation nonetheless).

Sometimes those interpretations turn out to be wrong turns, if not dead ends—it does happen. But that does not mean that mainstream medicine as a whole is therefore bunk. (Such interpretive wrong turns are merely part of the step-by-step research process, a process designed to safeguard the public I might add.) And even if you believe that mainstream medicine is bunk that does not then in turn imply that so-called alternative medical treatments are thus automatically largely effective if the quantifiable diagnostic evidence is not there.

Yes, there can be concerns with mainstream medicine, especially when vast sums of money, corporate or personal, are at stake. But I presume the role of the FDA and other government health-oriented agencies (NIH?) is largely to help combat the undue influence of corporations just looking for mere monetary profit and why those corporations cannot simply put new drugs and treatments on the market without some sort of rigorous fact-checking of presented evidence from closely scrutinized trials.

Yet even so there still can be serious questions as evidenced by this October 10th (2008) Discover article, Are Antidepressant Drugs Actually Worth Taking?, by Ben Harder, which notes the so-called "publication bias" whereby clinical trials which do not show a beneficial result are simply not published and therefore not taken into account.

I don't know that any of the rebuttal's presented "failures" of mainstream medicine ("ineffective AIDS vaccines?"; "Interferon?"; I confess I have no knowledge of "Thalidomide and Thorazine") were ever considered as "tried and true" treatments, ones that had made it through rigorous trials and had become anywhere near as accepted and widely used as, say, the standard flu or polio vaccines.

I think the whole debate would be better served by trying to do some sort of statistical analyses that would come up with a percentage of effective vs. ineffective treatments in both mainstream and alternative medicine, both overall and then also comparing both areas of medicine for how effectively they treat the same conditions. Any such analysis would of course be subject to cries of bias, but I feel that if agreed-upon quantifiable measures could be determined, the mainstream medical field would probably come out ahead. (Not perfect perhaps, but simply ahead.)

Do some alternative therapies have the potential to be effective for many patients? Yes, I believe so. But I think that for each "mainstream failure" instance cited by Drs. Chopra, Weil, and Roy, an equal or even greater number of alternative medical treatments for similar conditions can be pointed to as just as ineffective and sometimes even actively harmful (as opposed to "harmful" in the sense of merely wasting time while being ineffective).

Drs. Chopra, Weil, and Roy, seem to me to be merely tugging on peoples' fear-strings by playing the "little guy" vs. the "evil giant corporations" card while presenting no real evidence supporting CAM. Maybe presenting evidence was not their goal nor within the scope of their piece, but it would have been nice (I think) to see some sort of cited supportive references other than Mr. Null's.

As always, I could be wrong. This is just my own personal opinion based upon what the many voices in my head keep telling me over and over...

;-)

Dimension Skipper said...

I should have just said this...

1) I really think, Steve, that your article boiled down to "Show me the results, CAM!"

2) The Beliefnet response boils down to "Mainstream medicine is sometimes flawed, so therefore CAM must be beneficial."

If those charaterizations are basically accurate on my part (and of course they may not be), then personally I'll side with #1. But maybe that's just me.

Dimension Skipper said...

One addendum and I'm done...

In re-reading the rebuttal piece I now realize that they do refer to those "failures" of mainstream medicine as "medical theories":

The spectacular failures of "evidence based" medical theories include the millions spent on ineffective AIDS vaccines, the collapse of interferon as the wonder drug for cancer, and the marginal decrease in cancer deaths despite billions wasted during decades of fruitless research.

So they were NOT contending that those were standard full-fledged treatments as I mistakenly characterized their case earlier. I just wanted to clear that up and admit that I erred in my reading.

Steve Salerno said...

DS, I was in the process of reading and thinking about your longer comments when I came upon the third comment--and yes, that's it in a nutshell. This is what I've argued all along about all SHAM-based (meaning the movement, not the book) manifestations and derivatives in modern society, of which the phenomenal growth of CAM is just one.

That fundamental leap of faith--"If A isn't a perfect, unqualified godsend, well hell, then, let's all do B!"--is the slippery medium in which all these gurus flourish. Does mainstream medicine kill some people and disappoint some others? Of course! Is that a reason to begin, say, boiling dead cats and drinking the essence left behind in the water while chanting "hoo-la, hoo-la, HOO-LA!..." Call me crazy, but no, I don't think so.

"SHOW ME THE RESULTS, CAM." And show it to me in a format that can withstand the rigors of the scientific method. And don't tell me, "This methodology exists apart from your world of formal testing. This methodology exists according to its own rules."

Bull.

Elizabeth said...

Steve, Chopra et al. response has also been published on HuffPo -- here is the link:
http://tinyurl.com/7ram3r

Interesting readers' comments underneath, IMO (not quite what I expected; granted, Chopra et al. piece was not what I expected either).

"The opening salvo from the right" made me chuckle -- I could just imagine your reaction to these words :) -- and, judging by your re-response, you, justifiably, had one. (I liked your re-response, btw. Direct and on-point.)

DS, I too thought about the misleading data on antidepressants while reading Chopra et al. The suppression of the results about their ineffectiveness, along with the industry's penchant for inventing maladies (to be treated by new drugs, of course: Social Anxiety Disorder -- ask your doctor if Paxil is right for you!), is a good example of the criticisms that can be leveled against the "evidence-based" medicine as it is practiced currently in the US. This obviously does not automatically validate CAM, but it illustrates that the evidence is too often in the eyes of the beholder -- or, more accurately, the one who benefits from peddling the "cure." On both sides of this debate.

P.S. Oh, and there won't be any fracas. Mr. Null (is this a real name?) can have the title; it's just too much responsibility, you know. Besides, with the name like that, he is already destined for greatness. ;)

Dimension Skipper said...

I confess that I had some trepidation while pondering what I wrote last night only because I never know if I'm really coherent (!) at that hour of the morning. I'm actually glad to see that for the most part (I think) what I said kind of makes some sense even if I did ramble a bit. I wouldn't have been a bit surprised (and would not have objected) if you had not approved any or all of those comments, Steve, but am glad to see that you not only OK'd them, but agreed with my boiled down essence in summation.

Now, at the risk of demonstrating no small arrogance, I'm going to quote myself here to make two subsequent points I thought of only this morning in the light of a new day (and a new year):

Me, earlier: Drs. Chopra, Weil, and Roy, seem to me to be merely tugging on peoples' fear-strings by playing the "little guy" vs. the "evil giant corporations" card while presenting no real evidence supporting CAM. Maybe presenting evidence was not their goal nor within the scope of their piece, but it would have been nice (I think) to see some sort of cited supportive references other than Mr. Null's.

And so my related points are now:

1) I'd be curious to know some details of the personal finances of the Drs in question writing that piece. I'm not really familiar with Roy, but of course I've seen and heard of Drs. Chopra and Weil. I'm aware that both have written widely read and publicized books popularizing CAM and, I think, incorporating some "Eastern though" methodologies into CAM. I believe they've had more than a couple bestsellers and have whole itineraries of speaking engagements. So in addition to any actual medical practice it appears they have a not insignificant financial stake in CAM, to the point where I'm not even sure that the "little guy" label applies to them anymore, even compared to the big bad pharmaceutical corporations.

Note that I'm not against them making gobs of money. I'm only pointing out that if they're gonna raise an accusatory finger at big pharmaceutical's selfish profit motive, then maybe a similar finger can also be pointed right back at their own personal medical, publishing, and financial empires. They too have a large personal stake in CAM and CAM practices. Just a thought, something to consider.

2) When I say that I wish they'd cited supportive references other than Mr. Null's, I just wanted to point out that even that reference to Mr. Null's work was not really supportive of CAM, at least not the way that they mention it. No, that was raised merely as support of how mainstream medicine yearly has more than 300,000 avoidable deaths on its hands. The cited evidence of Mr. Null's statistics is perhaps not really evidence at all except in again pointing out the flaws in evidence-based medicine. (But then didn't we already know all that anyway?)

There is no mention of anything of Mr. Null's work going on to provide compelling statistics in actual support of CAM. Nor does it seem (on the face of it as cited) to absolve CAM of similar tangential harm and death as a result of various CAM practices.

I would be curious to see if there are any such numbers compiled anywhere showing CAM-related injuries and fatalities which perhaps could have been avoided as well. THEN we could perhaps compare evidence-based medicine and CAM on equal footing. Negative evidence against one thing does not in and of itself automatically provide positive evidence in support of something alternative to the alleged negative.

(OK, now I think I'm finally done on the subject... Some of that may have even been redundantly repetitive, especially in elaborating on #2, but I think my two basic main points this time were essentially new.)

Steve Salerno said...

DS: I still think the most telling point here resides in the fact that even NCCAM--New-Age medicine's very own, billion-dollar lobbying arm within NIH--is oh-so-equivocal (if not damning) on the fact sheets for its pet "healing modalities." As noted in my WSJ piece (and some of this had to be cut for space), page after page, you find the same, or strikingly similar, language: "...results were hard to interpret because of problems with the size and design of the studies..."; "...does not appear to prevent..."; "...does not appear to affect..."; "...studies were small and not well designed..."; "...to date, there is no conclusive evidence to prove its claimed uses..." And on and on. And yet NCCAM continues to cheerlead for CAM, continues to hand out millions upon millions in grants, continues to give consumers advice on where to find "reputable" CAM practitioners.

And let me say again: The absence of benefit does not imply the absence of side effects. E.g., look up the biochemical mechanisms of some of these herbs--and their possible interactions with more traditional (i.e. regulated) drugs. And/or go to Quackwatch and browse through some of the horror stories about people who put their faith in various forms of CAM. This is, of course, anecdotal evidence, and must be evaluated as such. It does not prove that CAM is worthless or even dangerous. It does, however, suggest that CAM, as an alternative to traditional medicine, is not benign. And remember, as per the rules of science and medicine, if I claim that my new therapy is "a remarkable breakthrough in treatment for X," then it's up to me to demonstrate my therapy's efficacy for the vast majority of people who suffer from X. On the other hand, a skeptic can shoot me down by merely citing a relative handful of cases in which my therapy doesn't work for X. The burden of proof is not equal; it resides chiefly with the person making the claim. This is why major clinical studies of new drugs are often suspended suddenly when a small handful of study volunteers begin dying or exhibit other worrisome side effects.

Dimension Skipper said...

As noted in my WSJ piece (and some of this had to be cut for space), page after page, you find the same, or strikingly similar, language: "...results were hard to interpret because of problems with the size and design of the studies..."; "...does not appear to prevent..."; "...does not appear to affect..."; "...studies were small and not well designed..."; "...to date, there is no conclusive evidence to prove its claimed uses..." And on and on.

It's not directly related to CAM and those who promote it, but one of my own little pet peeves is when ads (typically for specific food items, like cereals for example) try to promote a health benefit without actually claiming the health benefit directly: ...which emerging research suggests may help...

(And often the legal fine print presented for a fraction of a second cites only a miniscule statistical benefit at best if you can manage to freeze the image and read it.)

So the research is still only "emerging," it only "suggests" a correlation, and it "may" (and therefore "may not" is also implied) be helpful. Gee, sounds like a definite sure thing to me—by all means, load me up with ton's o' that stuff! [grin]

Elizabeth said...

As luck(??) would have it, this peach of a story that came to my e-mail box last night is related to *both* of your articles, Steve:

Hypnotherapist, 75, jailed for sex attacks

By Matthew Cooper
Tuesday, 23 December 2008
The Independent

A 75-year-old hypnotherapist was jailed for eight-and-a-half years today for committing a string of sex attacks on young girls during massage sessions.

Peter Knight was told by a judge that the offences were a breach of trust aggravated by the fact that his victims were targeted because their mothers were "vulnerable and credulous".

Knight, who claimed to be healing his victims, was convicted of 16 counts of indecent assault and three other sex offences last month following a two-week trial at Birmingham Crown Court.

The court heard the pensioner, of Selsey Road, Edgbaston, Birmingham, committed the offences against young women and girls over a 10-year period from the late 1980s to the late 1990s after billing himself as a spiritual healer who specialised in positive thinking.


Full text:
http://tinyurl.com/7kpety

Steve Salerno said...

DS: Don't even get me started on "emerging research"! What I want to know is, later on, when that early pseudo-promise is disputed by further analysis of the facts, how come they never run a follow-up ad that talks about "withdrawing research"?

Steve Salerno said...

But let's not forget, while we're at it, that there's a profound difference between an advertiser using cagey language to hawk a new product, and a federal agency that should be working in the consumer's best interests, trying to protect us from fraudulent claims. Or so you'd think.

Anonymous said...

"a spiritual healer who specialised in positive thinking"

So "The Poison of Positive Thinking" and "The Touch That Doesn't Heal" all in one. IOW, a CAM special.

Steve Salerno said...

Anon 5:19: Excellent point. A SHAM/CAM twofer.

Anonymous said...

Thanks, Steve. I'd like to take credit, but it was Elizabeth's point, I believe. Though "a SHAM/CAM twofer" has a nice ring to it.

Steve Salerno said...

Oops. Sounds like some of us need to read a bit more carefully.

Elizabeth said...

Ahem, some of us do indeed, LOL.

Thanks, Anon, for underscoring my point. I was trying to make it without pointing out the obvious. But perhaps I should point out that sometimes being too subtle can be pointless as one's point may get lost if not specifically pointed out. I hope I'm making my point clearly enough this time.

And now for something completely different: check out the bio of Dr. Rustum Roy, co-author of Chopra's response. This from Wiki (http://tinyurl.com/9tgxsu):

Roy was born, and received both BS and MS degrees in chemistry in India. He earned a Ph.D. in ceramics at Penn State in 1948, and became an American citizen in 1961. He had a long career at Penn State in geochemistry and materials science. He founded the Materials Science Laboratory at Penn State and authored hundreds of technical papers. Roy is a member of the National Academy of Engineering. His recent work has been on the relevance of the structure of water to homeopathy[1] which he defended from 'Homeophobia' by letter to The Guardian.[2]

And later we are told that among several things he authored is a book (written with his wife, perhaps) titled (I kid you not), Honest Sex.

I don't know why it makes me laugh (my congenital silliness may be at fault here), but the journey from Ph.D. in ceramics to sex -- and honest sex at that -- somehow tickles my funny bone. I'm a bit afraid to explore that "honest" part of his book, but may venture there out of dishonest diligence (aka prurient curiosity).

P.S. This should not be construed as an attack on Dr. Roy. For all I know, he is a decent and honest man. But I do wonder what exactly he contributed to Chopra's response.

Anonymous said...

Point well taken, Elizabeth.

Margaret Hampton said...

Steve,

It is unfortunate that you didn't have your fax correct when referring in your WSJ article about ABC Coding Solutions. ABC codes have been mapped to the closest approximate medical codes developed by the AMA or the federal government. This work was done to help the industry avoid processing fraudulent claims.

And, ABC codes cover a wide range of health professional services, not just CAM. Not having codes for non-physician care assures that no data is available on cost effective options to medical care. We all can agree that medical care in this country is not cost effective, and ABC Codes are offering a solution to that problem.

Steve Salerno said...

This morning so far I have received two comments from people defending Tony Robbins. I don't know whether these comments are part of an organized backlash--this has happened once or twice before--but the tenor of the comments is very similar, so I figured I'd treat them collectively.

Regular readers know that I have no qualms about posting opposing viewpoints, even very strong ones. Unfortunately, when people elect to litter their opinions with profanity and direct personal attacks, it results in my rejecting the comment(s). So whatever else they may have to say that is, potentially, worthwhile, never gets to see the light of day.

I must comment on something one of these critics said, however: "Please do not speak unless you are speaking from personal experience." Personal experience is the last thing we should be speaking from, if we're trying to evaluate these phenomena scientifically and arrive at some sort of overarching truth. The use (or misuse) of "personal experience"--anecdotal evidence, individual testimonials, etc.--is what keeps the snake-oil hucksters in business.

nells said...

Alternative medicine is just as effective and in some cases more so than traditional medicine. How many times has a drug study reported that the subjects getting the placebo achieved the same results as those getting the drug. Mind over matter. So if I want to get my feet massaged for 35.00 to relieve an ailment more power to me,,, It's my choice and so far I can still make that CHOICE..

In comes COdex Alimentarius, which will effectively make all natural supplements and herbs considered toxins and therefore must be regulated by big Pharma and Big Medical. Just another way for the huge corporate drug companies to close in on a viable market. All this "dissing" alternative medicine is just paving the way for this to go through. Perhaps you are being paid by one of theses companies to spew this misinformation.

For the sake of equality take a look at traditional medicine and how many people die every year from misdiagnoses, wrong drug therapy, overdoses, and other malpractice issues. Don't take the position that traditional medicine is the answer to all problems because it is being proven that it isn't.

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