My Response to An Alt-Muddled Friend
Harriet Hall, M.D.
AI've been discussing "alternative medicine" with a friend who is very intelligent but has no training in science. She uses chiropractic, magnets, vitamins, and acupuncture, and she says she doesn't care what science says because science can be wrong, she trusts her personal experience more, and if something "works" for her, she doesn't care how it works—she'll just keep using it. She is sure that any beneficial effects are genuine because the methods work for some things and not others. She assumes that a placebo would work reliably every time and that that any pain suppressed by a placebo effect would immediately return when the placebo was discontinued. She doesn't seem to realize that well-designed studies are needed to tell whether a product works or whether improvement is just the natural course of the ailment. I tried to explain that the very concept of a placebo-controlled trial depends on the fact that people can't distinguish between placebo and active drug. I tried to explain the difference between something that "worked" (i.e. pain gone after treatment) and something that WORKED (it was the treatment that made pain go away). As far as continuing to use what "works," I told her:
I go by my experience too. But I recognize that my experience may have misled me. I understand how that can happen, and I have seen it happen too often to imagine I am exempt. If a baseball player has found that he plays better when wearing his lucky underwear, that's may be sufficient reason to keep wearing it but not enough evidence to conclude that underwear affects athletic performance.
She depends on testimonials for her information: she chooses to try a method by talking to friends with a similar problem and hearing what works for them. If the method appears to be safe and reasonably inexpensive, she figures she can't lose anything by trying it. So I told her about Perkins tractors. They had plenty of testimonials; even George Washington used them. They went out of fashion after it was discovered that wooden sticks painted to look like tractors worked equally well. So they met her requirements: testimonials, low expense, safety. I asked her whether she would try the real ones or the wood ones first, since they both worked. She declined to answer on the basis that they weren't around any more and none of her friends were really using them.
She uses Nikken magnets and says she wouldn't trust any studies on magnetism that didn't use that particular brand because they were better. I sent her a list of links with studies specifically done with Nikken magnets, with information debunking magnets in general and specifically Nikken magnets, and about the Nikken company and regulatory action taken against them for false claims. She said she didn't have time to read them, but it wouldn't change her mind anyway, because Nikken magnets worked for her. She ended the discussion, agreeing to disagree, saying, "You have raised some valid points and made me think about my choices, which is good. I hope that some of the points I've made have done the same for you." I answered:
I'm afraid your points have not made me think, because I've heard them all before, and have already researched the facts, evaluated the arguments and rejected them. I work with these issues on a daily basis; I've read lots of books and articles, I've exchanged e-mails with world-class experts on both sides and I've heard the best that alternative medicine has to say for itself. The fact that our discussion made you think but didn't make me think tells me that I have read what you have about alternative medicine and you have not read what I have about alternative medicine, pseudoscience, critical thinking and the psychology of how people deceive themselves.
I'm surprised to see you relying on testimonials and "what works for you" in alternative medicine, just as I would be surprised to see you depend on a friend's opinion when choosing a car instead of checking out sources such as consumer reports and comparative statistics on reliability, safety, repair history and customer satisfaction. It strikes me as comparable to reading the first three names on a class roster and assuming the class is all women because the first three names happened to be women; you don't get good statistics if your sample size is too small. I don't imagine you depend on testimonials when deciding whom to vote for; I suspect you rely more on things like the candidate's platform, his actions in office, and his voting history.
Small children believe in the tooth fairy. It "works" for them, because they get money every time they put a tooth under their pillow. But as they get older, they usually want to know the "truth." I asked a gullible friend what she would think of me if I told her I still believed in the tooth fairy. She said, "I'd think that was sweet." I don't think it would be sweet, I think it would be pitiful. No matter how satisfying a false belief may be, I prefer the truth.
Some people have the philosophy that they can create their own reality; some prefer wishful thinking, random trial and error, and intuition to rational thinking and testing. The scientific method leads to one consensus answer; all other methods lead to several different, conflicting answers. I have come to believe that the scientific method, while imperfect, is the only valid tool for understanding reality. I like nothing better than changing my mind, because it means I was mistaken and I have been able to correct my mistake. Just as I gave up the tooth fairy, I have given up a whole slew of things, from the reliability of memory to ESP, because my original beliefs were contradicted by the evidence I found.
To rely on testimonials and to not wonder how things work or what science says about them is like having a set of the Encyclopedia Britannica and using it only to press flowers. Our brains are capable of much more and I think it is far more satisfying to use them to look at information that challenges our preconceptions and increases our knowledge.
I do my utmost to keep an open mind, but not so open that my brains fall out. I'm ready to accept any alternative treatment as soon as it is supported by convincing evidence (by the standards of the scientific method). I won't argue with you about alternative medicine any more, but I do hope you will read some of the arguments from the other side.
For Further Information
- Spontaneous Remission and the Placebo Effect
- Why Bogus Therapies Often Seem to Work
- Common Questions about Science and "Alternative" Health Methods
- Why Extraordinary Claims Demand Extraordinary Proof
- How Quackery Sells
Dr. Hall is a retired family practitioner and Air Force colonel who resides in Puyallup, Washington