Paul McCartney was twenty years old when the Beatles came to fame, and only twenty-four when, as legend has it, he was killed in a car accident in 1966 and replaced with a lookalike. Now, nearly fifty years later, if today’s McCartney is not the same man as the Beatle who recorded Help! and A Hard Day’s Night, he would still have used that name twice as long as the man born with it. And he would have had a musical career twelve times as long.

Perhaps this legacy is what has contributed to the steady decline of belief in the classic Paul Is Dead (PID) conspiracy theory. According to a 2013 survey by PPP, only 5 percent of respondents believe Paul McCartney died in 1966, a figure that barely surpasses the 4 percent of respondents who believe lizard people run the world. Popular conspiracy theories never completely disappear, but PIDers are as rare a breed of conspiracist as they come.

Tapes of “The Last Testament of George Harrison,” which supposedly support the theory that Paul McCartney died in 1966.

This makes the 2010 film Paul McCartney Really Is Dead: The Last Testament of George Harrison a curious outlier. The ninety-five-minute, direct-to-DVD “documentary,” produced by a company whose previous output included several Bob Dylan retrospectives and a couple of neocon political documentaries, proffered what it claimed was new and explosive evidence in support of the PID rumors. As the back of the DVD case explained:

In the summer of 2005, a package arrived at the Hollywood offices of Highway 61 Entertainment from London with no return address. Inside were two mini-cassette audio tapes dated December 30, 1999 and labeled The Last Testament of George Harrison. A voice identical to Harrison tells a shocking story . . .

Until now, the “Paul is Dead” mystery that exploded worldwide in 1969 was considered a hoax...Highway 61 Entertainment has corroborated most of George Harrison’s stunning account of the conspiracy to hide McCartney’s tragic death. Harrison’s complete audio tapes narrate this film that includes all the newly unearthed evidence. The Last Testament of George Harrison may prove to be the most important document of rock and roll history, leaving little doubt that PAUL McCARTNEY REALLY IS DEAD!

The same text also appeared on the film’s website, PaulReallyIsDead.com, along with high-resolution pictures of the envelope, mini-cassette recorder, and tapes. The film itself opens with the director, Joel Gilbert, telling the same story of how he received these tapes, and the years he spent studying them before making the movie.

DVD sleeve of the direct-to-DVD “documentary” Paul McCartney Really Is Dead: The Last Testament of George Harrison.

Gilbert also gave several interviews about the film, mostly to music websites. Over and over he told the backstory of the tapes, why he believed they were authentic, and why he thought the conspiracy story was compelling. He told ClassicBands.com that he’d taken the tapes to three different labs for analysis, and that they authenticated the voice as the real George Harrison. When DIY Magazine noted that the narrator didn’t sound at all like Harrison, Gilbert insisted that his interviewer was wrongly comparing the voice to the young Harrison, rather than Harrison as he sounded in the late 1990s. He told InDigest that he hoped 20/20 or 60 Minutes would do a more in-depth investigation of the material he’d presented in the film. And in a 2011 interview, several months after the film’s release, Gilbert claimed that he was legally protected in claiming that his film featured George Harrison’s voice because “the film is both journalism and a documentary.”

That, however, was all in 2010 and 2011. A visitor to PaulReallyIsDead.com today will get a far different impression of the film, as the site now prominently states: “The ‘Paul is Dead’ urban legend that exploded worldwide in 1969 was considered a hoax. In this mockumentary spoof of “Paul-Is-Dead,” a voice on mysterious tapes reveals a secret Beatles history, chronicling McCartney’s fatal accident. . . .”

The Highway 61 Entertainment website now lists the film under “Spoofs/Mockumentaries,” a category that the site didn’t have until 2012; before that, the production company simply called it a documentary. The film’s IMDb page similarly labeled it a documentary in 2010; today it is labeled “fantasy.” Reviewers in 2010 certainly saw it as a documentary, even when they didn’t think it was a very good one. One critic called it “one of the worst things ever put out using the Beatles name,” and another summed it up as being “so f*cking stupid.”

It’s hard to blame them, because the film might as well be a video demonstration of Poe’s Law and the impossibility of distinguishing between sincere extreme beliefs and parodies of the same. As the film presents it, the real Paul McCartney died in an automobile collision in 1966, and an MI-5 agent named “Maxwell” orchestrated an effort to replace him with a doppelganger, one William Campbell, who underwent plastic surgery to look more like Paul.

After this initial backstory, the bulk of the film is devoted to laying out the “evidence” for McCartney’s death and replacement, much if not all of it borrowed directly from existing PID claims. The film’s contention is that the surviving Beatles grew tired of the deception imposed upon them and sought to reveal the fraud through hints in their work. The film then spends most of the next hour of its running time detailing these supposed clues. But the resulting attention given to double meanings in lyrics and hidden messages on album covers doesn’t make for an entertaining satire; it makes for a boring catalogue of scattered conspiracist ideas.

In short, if an actual PID conspiracy theorist made a documentary film, it would look almost exactly like this, minus the claim that the narration is actually George Harrison’s voice.

The times the film departs from PID lore also don’t do much to cement it as a spoof of those beliefs, so much as a poorly researched conspiracy film. As reviewers pointed out, the film makes multiple errors in dates, citing “clues” about Paul’s death in lyrics and pictures that were actually produced before his supposed 1966 crash. Gilbert claims McCartney’s second wife Heather Mills was a witness to the 1966 crash, even though Mills wasn’t born until 1968.

He told DIY Magazine that “Dick Clark’s American Bandstand held a Paul McCartney look-alike contest in late 1966. This is a fact. However, no winner was ever announced, and we know for a fact that William Campbell had entered.” Literally none of those “facts” are true; Campbell was made up by a Michigan Daily writer in 1969, who invented many of the PID claims. Perhaps most interestingly, the film offers up at least one bit of “evidence” that Gilbert seems to have faked himself. In its closing minutes, during a montage, the film shows footage of George Harrison being interviewed on Australia’s The Midday Show, where he twice refers to “Faul,” the PID term for False-Paul. But the original interview footage doesn’t feature this mistake; in the 1988 interview, Harrison clearly says “Paul” every time. Gilbert actually used altered audio of the Harrison interview to fool his audience, and then dropped the manipulated footage into a clip montage. Nothing about the clip itself tips its hand that it’s supposed to be satirical instead of sincerely conspiratorial; only by finding and comparing the original footage does one discover that it’s been manipulated.

The envelope in which Joel Gilbert supposedly received “The Last Testament of George Harrison” tapes.

Paul McCartney Really Is Dead wasn’t Gilbert’s final foray into celebrity conspiracy theories. In some 2011 interviews, Gilbert called his McCartney film a “Rock-U-Mystery” and said he had another such film in the works. Eventually released in January 2012, Elvis Found Alive had Gilbert claiming that he’d uncovered FOIA documentation that led him to a still-living Elvis Presley, who granted him an interview, supplied the narration for Gilbert’s new film, and recorded a new album that Gilbert then released. The film itself is even more absurd than the McCartney movie, since everything about Presley’s “life” after 1977 had to be completely fabricated. Occasionally the author’s own voice peeks through, as when “Elvis” shares some unexpectedly strong opinions about Barack Obama and his supposed socialist agenda.

Nonetheless, just like the Paul film, Elvis Found Alive was marketed as a documentary. And just as the Paul website was edited, a similar change was made to ElvisFoundAlive.com. Where the site once read “ELVIS has been FOUND, ALIVE!”, today it starts “In this new mockumentary spoof of Elvis theories, Elvis has been FOUND ALIVE!”

Even though the films were released some sixteen months apart, their websites were edited and altered at roughly the same time. According to the Internet Archive’s Wayback Machine, PaulReallyIsDead.com redesignated its film to be a “mockumentary spoof” sometime between March 6 and May 2, 2012, and ElvisFoundAlive.com was edited between April 15 and June 20, 2012.

That period of time was not insignificant for Gilbert, because in April 2012 he began publicizing his next “documentary,” a purported exposé of Barack Obama’s Communist roots titled Dreams From My Real Father, by launching a website and doing early promotional interviews. On the surface, Dreams has every indication of being in exactly the same vein as Gilbert’s McCartney and Elvis films. It purports to be a documentary exposé of a famous individual’s life, pushing an alternate historical narrative of conspiracies and cover-ups, assembled from archival footage without any original interviews, and tied together with a voiceover narration by a celebrity impersonator. The difference is that, both in 2012 and today, Gilbert insists that Dreams is totally serious. He even mailed copies of it to millions of voters in swing states just before the 2012 election.

But as hard as it would be to sell the public on a “documentary” about Obama’s secret Communist past, it would be even harder when the studio’s last two celebrity-centric films were laughable nonsense packaged as “documentary” features. So just as the publicity for Dreams From My Real Father began, the McCartney and Elvis films were retroactively designated to be “spoofs.”

The satirical conspiracy documentary isn’t unheard of, but it’s not common. The 2002 French mockumentary Dark Side of the Moon pretended that the Apollo 11 moon landing was a Stanley Kubrick-directed fake orchestrated by the CIA and featured creatively edited interview clips and fake witnesses played by actors as part of its feint. Sociology students shown the movie as part of a conspiracy theory study confused it for a serious film. Incident at Loch Ness, a 2004 mockumentary by Werner Herzog and Zak Penn, purported to show an encounter with the Loch Ness monster in behind-the-scenes footage of a Herzog film, but the entire movie is actually a nested film-within-a-film-within-a-film, with all the stars playing themselves. Both of these films, however, succeed as entertainment in their own right; an ignorant view might confuse Dark Side of the Moon with an actual conspiracy film, but there’s no mistaking the intention of its creators.

But where those succeed, Paul McCartney Really Is Dead still fails. Not only because it’s mostly a bland recitation of supposed conspiratorial clues, but because it doesn’t seem to serve any purpose other than to promote the Paul Is Dead conspiracy theory. It’s difficult to view Paul as a satire of conspiracy theories, when it is basically just a straightforward presentation of those conspiracy theories. It’s not persuasive enough to be compelling and not outrageous enough to be entertaining.

So is this a case of a conflicted conspiracy theorist, an elaborate exercise in performance art, or an exercise of the crassest sort of commercialism? Is Gilbert part of the 5 percent who still cling to the Paul Is Dead conspiracy, or did he just pretend to adopt its beliefs for the sake of selling DVDs? Was the film rebranded as a “spoof” to be more honest, or was that simply Gilbert putting distance between his silly Rock-U-Mystery films and the new conspiracy film that he hoped would turn the 2012 election?

Whatever the motivation, the film does succeed in doing one thing: its failure demonstrates that even if the Paul Is Dead conspiracy theory isn’t pushing up daisies itself, it’s certainly on life support. Even a flashy DVD can’t make it seem credible to modern audiences. So whereas most celebrity death conspiracy theories, be they JFK or Tupac or Princess Diana, begin with an actual death and live on as part of the person’s legacy, Paul McCartney may actually accomplish the novel feat of outliving his own celebrity death conspiracy theory.

References

James, Gary. 2010. Gary James’ Interview with the Producer of Paul McCartney Really Is Dead, The Last Testament of George Harrison. Online at http://www.classicbands.com/JoelGilbertInterview.html.

Kapranos, Alexia. 2010. “Paul Really Is Dead” Says New Documentary. DIY Magazine (June 28). Online at http://diymag.com/archive/paul-really-is-dead-says-new-documentary.

Marinucci, Steve. 2010. Review: ‘Paul McCartney Really Is Dead’ DVD is beyond bad – it’s tasteless and stupid. AXS Entertainment (July 12). Online at http://www.examiner.com/article/review-paul-mccartney-really-is-dead-dvd-is-beyond-bad-it-s-tasteless-and-stupid.

Mavis, Paul. 2010. Paul McCartney Really Is Dead: The Last Testament of George Harrison. DVDTalk (August 30). Online at http://www.dvdtalk.com/reviews/45598/paul-mccartney-really-is-dead-the-last-testament-of-george-harrison/.

McGahee, Geno. 2011. The Beatles, Boxing, and Bob Dylan: Joel Gilbert Speaks. Scared Stiff Reviews (February 6). Online at http://www.scaredstiffreviews.com/?p=662.

Nelson, Dustin Luke. 2010. An Interview with Joel Gilbert, director of Paul Really Is Dead. InDigest (November 1). Online at http://indigestmag.com/blog/?p=5589#.VA_dnvldUrV.

Williams, Jim. 2013. Conspiracy Theory Poll Results. Public Policy Polling (April 2). Online at http://www.publicpolicypolling.com/main/2013/04/conspiracy-theory-poll-results-.html.

The Dutch-speaking skeptical landscape

For a bit of context, let me take you on a short tour around the skeptical movement in the Dutch-speaking world. This includes the Netherlands and Flanders (Northern Belgium). In total there are four active organizations; two in the Netherlands and two in Flanders. In the Netherlands the Vereniging tegen de Kwakzalverij (Society Against Quackery) or VtdK, founded in 1881, is the oldest skeptical organization in the world. The VtdK specifically focuses on fighting harmful or useless (alternative) medicine. The second organization in the Netherlands is Stichting Skepsis (founded in 1987 with the help of Paul Kurtz), which focuses on skepticism in general. In Flanders there is SKEPP (founded in 1990 with the help of James Randi and Skepsis), also focused on skepticism in general. Het Denkgelag, the fourth group, is a recent offshoot from SKEPP (althought they're not competing, rather completing each other) that was founded in 2012 to hold discussions and lectures aimed at attracting people outside the skeptical community, and stimulating critical thinking. The four groups often work together and support each other's actions through coordinated events such as the 10:23 Campaign in Amsterdam, and in 2009 Skepsis and SKEPP started up a support fund when the VtdK came in financial troubles because of a lost lawsuit (they could not call a quack a 'quack'; later this case was reopened, however, and ruled in favor of the skeptics). Besides these four, there are also several humanist and freethought groups that are especially skeptical about religion.

My first conferences

Since I became a skeptical activist 2 years ago, I have been to several conferences. On 17 October 2013, Het Denkgelag organized an event at Ghent University, which was attended by a thousand people, was mainly a discussion between three American top scientists (Lawrence Krauss, Daniel Dennett and Massimo Pigluicci, moderated by Flemish philosopher Maarten Boudry) and was not an ordinary skeptical convention. The VtdK symposium on 4 October 2014 was very interesting, but mainly restricted itself to alternative medicine (especially acupuncture), and was principally intended for an ingroup of physicians (non-members had to pay absurdly high entrance fees). Therefore, the Skepsis Congres is the best example of a skeptical conference in the Dutch-speaking world: it is accessible for lay people, there is a lot of interaction with the audience, and they address any and all skeptical issues without specialization. It has been held annually since 1988, most often in Amersfoort or Utrecht because of their central location within the Netherlands. There are also frequently speakers invited from Belgium, Germany, the United Kingdom or the United States. Attendees are mostly from the Netherlands, and to a lesser extent from Belgium.

This would become my fourth skeptical conference; in April 2014, I also attended QED: Question, Explore, Discover in Manchester, which really was a wonderful experience. I was very excited to meet old and new friends, and recruit people for Guerrilla Skepticism on Wikipedia (GSoW), the project initiated by Susan Gerbic that I've devoted most of my spare time to in the past 1.5 years as the Dutch language team leader.

Tribute to Rob Nanninga

Nanninga's Wikipedia page on display (Photo: Leon Korteweg).

This year, the Skepsis Congres had 'Crisis in Science' as its theme. The first session was about the current state of affairs within Stichting Skepsis, especially after the passing of Skepter editor Rob Nanninga, whose Dutch Wikipedia page I had recently written. I have now also translated his biography to English, which appeared as a 'Did you know...' on English Wikipedia's Main Page on 18 February 2015. Nanninga's life was discussed in detail, and how, during his 25 years as editor, of which 10 were as editor-in-chief, he had engaged in informing the public with reliable information by critical investigation, including countless experiments he had performed to test extraordinary claims. He leaves a great hole behind him in Skepsis, that could not be immediately supplanted; they were still looking for an apt successor. Simultaneously however, Nanninga has long obstructed modernisation of Skepsis: for example, he wanted no part of the new social media, articles always have to have been well-researched and serious in style, there could be no quick and short humorous refutations of everyday falsehoods, and during his management, the website kept a '90s look. With him gone, a lot of reforms are now being conducted that members had been demanding for a long time. Fortunately, as was announced 6 weeks later, renound science journalist Hans van Maanen, who was present at the Congres and discussed the matter confidentially with the board that day, had shown interest and eventually agreed to becoming the new editor.

Skeptical outreach

Clockwise: Emile, Coen, Leon, Vera.

Secretary Jan Willem Nienhuys, who acted as master of ceremonies during the Congres, has a good story about the state of Skepsis. With a great sense of humor, he informed us about recent correspondance and news items, and reported on the finances. Fortunately the foundation is quite wealthy, and there is ample funding available for new initiatives. During the Q & A, he asked if anyone had 'good ideas for Skepsis', and that's when I succeeded in getting the microphone, even though I showed up late and I'm not well-known within the Dutch skeptical movement (yet). I would have met up with my team members, but had no idea yet where in the room they sat. Coen and I, who had been collaborating online for months, made our first real-life eye contact when the microphone was brought to me, and once I started speaking, Vera (who sat in the front row to take pictures of the speakers for Wikimedia Commons) recognised my voice, turned around and smiled at me. I felt tense as 250 pairs of eyes were directed at me (or at least 250 pairs of ears), but I did it. My first statement advocated setting up an official skeptical podcast for Skepsis, and to fund it liberally; –comparing it to the methods used for the Kritisch Denken (Critical Thinking) podcast–, in order to reach a much broader audience with skepticism. My second statement was to request attendees please join us to improve and expand Wikipedia, with the goal of making it more skeptical! I gave the example of Nanninga's page, when Nienhuys interrupted me: 'Yeah, I've already shown that,' and he went back a few slides and put up a screenshot of his WP page!! I said: 'Wonderful! Sorry I missed that, I was late, but great! So you all already know what we do and how you can help. Come talk to me during the break, I'll explain everything. We are (*prominently showing my T-shirt*) Guerrilla Skepticism on Wikipedia, come join us!' Nienhuys then said: 'And what is your name, so people know?' I said: 'Leon Korteweg!' Nienhuys: 'Thank you, Leon!' And I got a round of applause. The remainder of the Q & A, Nanninga's page was shown to the audience; I can't imagine a better outreach moment for GSoW. Although I was slightly shaking on my legs, and for 15 more minutes afterwards on my chair, I had succeeded.

New recruits! (Photo: Vera de Kok)

Crisis in science

A while later Emile also entered the room; he is the skeptical rogue of the Dutch team, trying to remove nonsense and challenging dubious claims wherever he finds them. The sessions thereafter were all highly informative and often comical though disquieting lectures from top scientists, showing that science is in a state of crisis: sloppy trials are done, there is a lot of fraud going on to pretend the results are positive so that research funds can be secured and products can be sold, and of course there is massive publication bias. The speakers Ruud Abma (teaches General Social Sciences at Utrecht University), Gustaaf Cornelis (teaches philosophy of science at the Vrije Universiteit Brussel and the University of Antwerp), and Yvo Smulders (professor of General Internal Medicine, VU University Amsterdam) focused mainly on medicine. But it happens in other fields like psychology and sociology as well, Diederik Stapel being a notorious Dutch example who confessed his fraud and apologized, but he is just the tip of the iceberg. Such practices are very harmful to society, because costly trials are unnecessarily repeated because earlier negative results were never published, and medicines that don't work or can even harm patients manage to slip through the review process due to commercial and financial interests. We shouldn't just be skeptical about pseudoscience, but also extremely critical of all corruption within real science that is out of control. Proposed countermeasures to make science healthy again included decreased publication and performance pressure and early education in scientific ethics.

A wonderful day ends

I estimate that, thanks to Coen's design and printing, we were able to hand out our stylish GSoW business cards to about 90% of the attendees, and a number of those we also gave cards of Kritisch Denken. We recruited at least two new members on that day alone, and hope that more will contact us later. During the lunch break I also had the opportunity to hold an informal interview with Catherine de Jong (chair of the Vereniging tegen de Kwakzalverij and board member of the European Council of Skeptical Organisations), in which I obtained important information for my Wikipedia draft article about her, and I let her review it on my phone (because science!). I talked in depth and also briefly with a lot of different people, and afterwards Emile, Vera and I dined with several Skepsis board members, who are among the most active in the movement, sharing their experiences of how they had and are making a change by reaching the Dutch public with skepticism. What an amazing day.

Dining with Skepsis board members.

Four Revolutions in the Earth Sciences: From Heresy to Truth. By James Lawrence Powell. New York: Columbia University Press, 2015. ISBN 978-0-231-16448-1. 384 pp. $35.

The scientific skeptic recognizes that even generally accepted scientific ideas might be wrong, but as skeptics we also need the intellectual tools to understand how consensus is achieved in science and what it means. James Lawrence Powell1, who has written several excellent books on contemporary issues in the geosciences (including Night Comes to the Cretaceous, Grand Canyon, and Dead Pool) and global warming (The Inquisition of Climate Science), was challenged to write this book by a friend who asked him how he could be so sure of the reality of global warming. After all, “science has been wrong before.”

The simple answer is that scientists accept theories when the data demand that they do so. However, the process is not simple, and there have been times when entire scientific communities pursued dead ends and persisted in error even in the face of transformative new data.

To explore this question, Powell has analyzed four fundamental discoveries in the geosciences that are central to understanding our planet: the age of the Earth, the formation and evolution of its major landforms, the role of cosmic impacts, and the stability of our atmosphere and climate. Powell has written a compelling narrative of the ideas and personalities that shaped these big questions over the past two centuries. This is first-rate story telling, with heroes, villains, and the often-unexpected discoveries that created revolutions in our concept of our planet.

Some major themes recur in these histories. One is the conflict between traditional geoscientists and their outside critics, especially physicists. The descriptive and historical scientists often closed ranks against anyone who was not steeped, as they were, in the details. The outsiders, in contrast, insisted that their critics simply did not understand the requirements of “natural philosophy.” Another recurring issue is whether descriptive data can be trusted in the absence of a full theoretical underpinning. The history of continental drift provides an example, with the compelling empirical arguments of Wegener discounted because he proposed no viable way for continents to move. Finally, there was the influence of some senior scientists who, having achieved positions of influence or authority in universities or government agencies, effectively closed the door on innovations that challenged their magisterial position.

Let’s look very briefly at each of these revolutions before returning to fundamental questions about whether we can be confident in any of these areas that we have finally got it right. This is especially important when Powell discusses climate science, where clearly many members of the public don’t think we have it right.

Age of the Earth

In eighteenth - and early nineteenth-century England, James Hutton and Charles Lyell defined the principles of uniformitarianism, asserting that the same processes that act today have always done so, in an endless cycle, with “no vestige of a beginning, no prospect of an end.” To them, the question of the age of the Earth was irrelevant. The uniformitarian philosophy was challenged by Darwin’s concept of biological evolution, but the most fundamental critiques came from physicists led by Lord Kelvin. He asserted that uniformitarian principles violated the laws of thermodynamics and that a sort of geological perpetual motion machine was impossible. Kelvin went further and used the principles of thermodynamics to estimate both the age of the Earth (the time needed for it to cool) and the age of the Sun (its lifetime generating energy by contraction). Both numbers were in the tens of millions of years, and the physicists asserted that older ages were “impossible.”

At the turn of the twentieth century, the situation changed dramatically with the discovery of a new energy source. Radioactivity falsified Kelvin’s calculations for the age of the Sun and provided ways to calculate the age of the Earth. These calculations were not easy; it required decades of improving technology to assemble the tools to do the job, and ultimately the age of the Earth was tied to the age of the oldest meteorites. The current best value is 4.56 billion years.

Plate Tectonics

One long-lived offshoot of uniformitarianism was the assumption that continents and ocean basins were permanent and immobile features of the planet. In the first decade of the twentieth century, Alfred Wegener challenged this assumption by his investigation of the Atlantic Basin, where not only do the coastlines of Africa and South America line up like pieces of a jigsaw puzzle, but the detailed geology and fossil records on both sides demonstrate continuity across what is now a 4,000-km ocean gap. The conventional explanation for these similarities (if they were acknowledged at all) was that a long land bridge had connected the two continents. Although such fanciful land bridges violated the principles of physics by alternately rising and sinking, this problem was ignored. Wegener, as an astronomer and meteorologist and even—God forbid—an Arctic explorer, became a non-person. By midcentury, the words Wegener and continental drift had been purged from geology texts. Geological history was all a matter of rising and sinking motions, never sideways.

A way out of this intellectual dead end came from new disciplines of geosciences and new people entering the field, using the remarkable advances in data collection that followed World War II. Sea-floor maps clearly showed the mid-ocean ridge where the two sides of the Atlantic had parted, and paleomagnetic studies mapped the alternating bands of magnetism that traced the movements of continents. Today we can even measure their motion directly using GPS. In 1965, the sea-floor spreading idea was extended to plate tectonics, now the most fundamental concept of terrestrial geosciences. However, as late as the 1970s, several of the most respected senior scientists refused to accept any of this “nonsense.” Powell writes, “those who continue to insist they were right the first time, in spite of accumulating evidence to the contrary, are stuck forever with their original belief.”

Cosmic Impacts

Although pioneering work at the end of the nineteenth century had suggested that lunar craters were impact scars rather than volcanic features, these ideas had almost entirely disappeared by the mid-twentieth century. It was geological dogma that geologists should look at what was happening at their feet and not indulge in speculation that some cosmic intervention could solve their problems. But after mid-century a new generation of interdisciplinary “planetary scientists” was stepping up. Ralph Baldwin measured thousands of lunar craters and concluded they could not be volcanic; Gene Shoemaker’s detailed field work at Meteor Crater demonstrated beyond a doubt that this particular feature, at least, was an impact scar; Nobel Laureate Harold Urey changed his major research direction to study theories of lunar origin; and a young Bill Hartmann used astronomical data to correctly estimate an age of the major lunar features of three billion years. However, most geologists ignored these upstarts. In 1964, on the eve of the first NASA lunar missions, attendees at a major conference on Geological Problems in Lunar Research were nearly unanimous that the lunar craters were volcanic. One leading speaker declared that meteorite impact is a “trivial process in affecting both the geneses and development of almost all major lunar features.” In a matter of months the Ranger, Surveyor, and Apollo missions began to arrive at the Moon, and the rest is history. New data again provided the key.

Recognition of the role of cosmic impacts in terrestrial and planetary history is now nearly universal. Powell devotes the second part of this story to ideas that are more controversial: the proposed giant impact origin of the Moon, and the role of cosmic impacts in the biological history of our planet. His earlier book, Night Comes to the Cretaceous, is one of the best accounts of the controversies surrounding the Chicxulub impact and the KT mass extinction. There are few scientists today who do not credit an asteroid impact with the extinction of the dinosaurs, but questions remain about the details, particularly if the KT is the only mass extinction associated with an impact. It is dangerous to generalize from a sample of one.

Global Warming

For many readers the section on global warming will be the most interesting topic in Powell’s book. Here he steps back from today’s headlines for a unique guide to the early history of the science behind global warming—ideas that stretch back to the nineteenth century.

The greenhouse effect was first suggested by the discovery that light rays and heat rays have different ability to penetrate glass, and were thus capable of heating the inside of a glass enclosure exposed to the Sun. In 1836, this idea was extended to the role of the atmosphere in heating the Earth, and the gases carbon dioxide and water vapor were identified as playing a similar role to the greenhouse glass. At the end of the nineteenth century, Svante Arrhenius first calculated the magnitude of the greenhouse effect and estimated that doubling the amount of CO₂ would cause a temperature rise of about 5°C. There was a problem, however: water vapor and carbon dioxide had overlapping infrared spectra, and water vapor seemed to be the dominant absorber. Therefore most meteorologists early in the twentieth century concluded that CO₂ made only minor contributions to the atmospheric greenhouse.

Meanwhile, a key insight emerged from joint consideration of radiative and convective processes in the atmosphere. When moving heat, convection in a fluid dominates over conduction or radiation, and the lower atmosphere of the Earth is convective. Water vapor is largely confined to the lower regions, but CO2 is the dominant absorber in the stratosphere, above the convection layers. This leads to the following simple picture of the effect of CO₂ on temperature.

1. On average the Earth must be in equilibrium, radiating the same energy it receives from the Sun, which is equivalent to that of a “bare rock” planet about 30°C cooler than the current surface temperature.

2. The effective radiating layer is primarily dependent on the carbon dioxide concentration in the upper atmosphere, where there is little water vapor. In the troposphere, heat is transferred primarily by convection and is largely independent of the infrared absorbing gases.

3. Therefore, the equilibrium surface temperature can be found by using the temperature gradient (lapse rate) in the convective troposphere to maintain the correct temperature in the stratosphere at the effective radiating layers.

4. One of the key signatures of greenhouse heating is that while the surface temperature rises, the stratospheric temperature actually declines.

Unfortunately, by the time this concept was developed the meteorology community had largely abandoned the idea that CO₂ was a major contributor to surface temperature. They took note only when evidence accumulated that the temperature was in fact rising in parallel with the increase in atmospheric CO₂, which in turn was tied to the release of carbon from burning fossil fuels.

The actual task of modeling a complex system like the Earth’s atmosphere is formidable, taking into account both global atmospheric circulation and radiation, modulated by ice, clouds, and weather. Today’s climate scientists are working at levels of detail unimaginable fifty years ago. But it is valuable for Powell to point out that the fundamental concepts of global warming were established even before World War II.

Powell’s original question was how we know anthropogenic global warming (AGW) is real. The simple answer is that the data demonstrate it. It has become almost impossible to deny that the planet is warming, based on multiple independent evaluations of the measured surface temperatures, global remote sensing from orbit, and large-scale environmental changes, especially in the Arctic. But how do we know that the primary cause of global warming is CO₂ from burning fossil fuels? Because both theory and data show that temperatures rise with atmospheric CO₂ concentrations, and the isotopic analyses of the added CO₂ demonstrate that it came from the burning of old carbon (fossil fuel).

To go beyond these simple truths, particularly to predict the course of future warming, scientists must delve into complex calculations and computer models that are difficult for laypersons and even most scientists to judge. Here we have an advantage over the historical examples Powell cites, since there are thousands of climate scientists around the world working on these problems, checking each other’s work. For example, the Intergovernmental Panel on Climate Change reports represent researchers from 195 countries, and UN rules require unanimity in approval of the report language on climate change. Today we are flooded with climate data, and ultimately it is data, not models, that matter in science.

In his final paragraph, Powell summarizes:

Of course scientists have been wrong in the past, but they did not stay wrong. As new data arrive, scientists changed their position, some enthusiastically, some begrudgingly. A few were unable to make the transition, going to their graves clinging to their long-held positions. A new generation, with no allegiance to the old ways, came along to replace them. Thus data transform heresy into truth.

Note

Powell, a geologist and geochemist, has been president of both Reed College and Franklin and Marshall College, acting president of Oberlin College, and director of the Los Angeles County Museum of Natural History. He also served twelve years on the National Science Board, and he is now president of the National Physical Sciences Consortium.

For over a month now, I have read over Belle Gibson’s The Whole Pantry (Over 80 New Recipes With a Back-To-Basics Approach to Wellness, Lifestyle And Nutrition)–a book that reportedly has been removed from the shelves, but is readily available at my local bookstore and the local library–and find myself repeatedly going back to the disclaimer on the back of the title page:

The information of this book is of a general nature. It is not intended to constitute professional medical advice and is not a substitute for consulting with your doctor or other healthcare provider. The publisher… and author… are not responsible for any adverse effects or consequences arising from the use of any suggestions, preparations or procedures included in this book. All matters relating to your health, including diet, medication and appropriate physical activity, should be discussed with your doctor.

So is Belle Gibson to blame for what happened next? She began as a cancer survivor, a seeker of wellness, a user of Instagram who tapped into a “community” that has supported her creating “the world’s first health and wellness lifestyle app,” which was to be a featured application on the Apple Watch App Store.

Her name is now associated with lying about cancer conditions, profiting from her reputation as a “wellness blogger”–and has gained hundreds of angry and upset comments online after her appearance on Australia’s 60 Minutes current affairs program (especially after rumors that she was paid for the interview).

If you skip the thirty or so pages at the front of the book which detail Gibson’s “Philosophy” behind the recipes–“[bringing] together the integral needs of a balanced life… your new space for inspiration, health, wellness and lifestyle support”–I honestly don’t think this is much of a cookbook.

I still can’t figure out on what basis Gibson ranked her “Australian” version of the USA Environmental Working Group’s “Dirty Dozen” and “Clean Fifteen” organic vegetable lists. She claims on page 68 that “as a general rule, it’s good to avoid the hormones and fluoride in tap water” and that soy milk is “typically genetically modified.” The extraction of probiotics from a handful of capsules in order to make Cultured Cashew “Cheese” on page 180 is weirdly at odds with the organic trend of the meals.

No one is willing to taste the Chocolate, Raspberry, Beetroot and Zucchini Breakfast Muffins (page 84) that took me three shopping centers to find the gluten-free baking powder for, until I lie and say they’re just plain chocolate chip.

I try making the Asparagus and Zucchini “risotto” from page 94 and everyone asks why I’m serving Hummus dip for the main meal. I would probably try the Poached Eggs with Green Smash and Hazelnut Dukkah for breakfast again, if it wasn’t for the fact it took me over half an hour to make it… and let’s face it, plain coffee and toast has much less washing up involved.

After seeing spirulina (blue-green algae) listed as the key ingredient for the scrub and soak mixture, I check the rest of the recipes to see if it’s included elsewhere (it isn’t). However, it is praised on page 12 as a “superfood” that encourages liver function, anti-inflammatory, and anti-bacterial (even though there’s no apparent evidence for this).

Now I am settling into a diet without a label, because gluten-, grain-, mostly dairy- and egg-free, anti-inflammatory, with Ayurvedic principles is just too much to stick into one category.

Belle Gibson’s The Whole Pantry, page 9

While the recipes weren’t really to my liking, it’s the first two-dozen or more pages of the cookbook are the most distasteful aspect:

I said right from the start that I was a brain cancer patient, on a quest to heal myself naturally. I was totally overwhelmed by the immediate response to my first posts… what I was writing about was really resonating with my community, and it still amazes me how we’ve all come together.

What do you think it was about your Instagram posts that attracted so many followers?

Authenticity and integrity. It really is that simple. Too many people over-edit themselves. There’s not enough honesty out there. It’s human to feel sick, to ask questions, to search for answers… I used to feel quite self-conscious and sheltered, but now I embrace rawness and honesty. Never refine yourself in a way which takes away your heart, message and truest self.

Belle Gibson’s The Whole Pantry, page 2

Belle Gibson writes that while she has a simple life in mind for the future, she also has more products in the pipeline and “collaboration on school-building and other international projects.” It is unlikely this will ever happen now.

To unpack the ramifications further, I interviewed Dr. Ranjana Srivastava, a medical oncologist and author based in Melbourne and the award-winning author of So It’s Cancer, Now What?

Kylie Sturgess: How pervasive are alternative medicine claims in regards to cancer cures? Is it something that comes up often in your practice?

Dr. Ranjana Srivastava: The whole alternative medicine industry is worth billions of dollars, and so, I think it would be safe to say that you can take it for granted that most people whom I encounter in a cancer clinic have looked into or tried some form of alternative medicine.

Now, that may be something as benign sometimes as vitamins or supplements, although, there is evidence that even high doses of some vitamins can be detrimental to health.

Or, it may be exotic things like herbs and spices, or exotic juices, powders that people import from all over the world. I see a range of things. Some people talk about them, other people ask me for advice about what to do, and then, there is a large number of patients who would simply not think that it’s something to be discussed in an oncologist office.

Sturgess: Now, there’s been a recent backlash against Belle Gibson–people are angry at the media for raising her profile, at the wellness industry in general–and of course, at Gibson herself. Is it too simplistic, do you think, to blame one factor when it comes to miracle cancer cure claims?

Srivastava: The Belle Gibson story has certainly caught people’s imagination, and a lot has been said and written about this.

I guess people can make up their own minds about how much or how far they were duped, but I would say that these alternative therapy products, whether they have to do with diet, exercise or whatever, thrive because we support them, and we buy into them.

And so, I guess the fault lies as much in us as consumers as in the people who are peddling this kind of false stuff. I am sympathetic towards people that feel that they have been duped, or who have lost a lot of money, or have wasted their health sometimes on these things, but ultimately, I think we have to be responsible, I suppose, for what we buy and what we believe in.

Sturgess: What are some of the things that people should be wary of when looking for help with health conditions?

Srivastava: I think that old adage about, if it sounds too good to be true, it probably is! It’s an easy one to remember, and time and time again it’s proven to be true. It’s something certainly that I would encourage people to keep in mind. I would be the first to say that all advice, including medical advice, should be taken with an open mind.

People should question and also aim to understand whatever it is that they are being told, whether it’s by a doctor, by any manner of other health provider, or someone else. But at the end of the day, I think if you look at the conventional medical advice that you are receiving, and if you compare it to some alternative therapy advice? The alternative therapy will guarantee the cure for cancer, or for any number of conditions, which seem too good to be true. So, I think you do have to go back and look at it with some skepticism.

I don’t know how else to advise patients. It’s heartbreaking when this happened, and as a doctor, I see the end results of someone having gone down this kind of extreme alternative territory line. But we are all consumers, and we have to take responsibility for what we consume.

Sturgess: Finally, with people becoming more aware of scams, with increased media attention on claims, Belle Gibson is just one example. Should we be optimistic about improvements on online health advice?

Srivastava: I think there is a whole range of health advice on the Internet that’s good advice, and it comes from reputable sources. For example, in Australia, when talking about cancer, I would recommend the Cancer Council website, for example.

You can go to Cancer Council Australia, and now, you can find a variety of really good advice and support services, and how to access different things on that site. But I think that there will always be a range of sites that peddle poor information, that sell falsehood, that sell miracle cures, and it’s very easy to do.

We see in the era of the Internet, anybody can put up a blog. I don’t know that that’s necessarily something we are going to be able to strongly regulate, but I would say to people that they need to be savvy, and ask their doctors, or ask other people they trust about trustworthy sites.

A Scientist in Wonderland: A Memoir of Searching for Truth and Finding Trouble. By Edzard Ernst. Exeter, UK: Imprint Academic, 2015. ISBN: 978-1845 407773. Softcover, £14.99.

If you have any interest whatsoever in complementary and alternative medicine (CAM), Edzard Ernst’s new book A Scientist in Wonderland is a must-read. If you are already skeptical regarding CAM, you will enjoy an entertaining and informative insight into the life of a man who can reasonably claim to have carried out more high-quality research in this area than anyone else alive.

If you are a believer, there is even more reason for you to read this book. In it, Professor Ernst clearly presents his reasons, based upon sound empirical evidence, for concluding that the vast majority of CAM treatments are therapeutically worthless (over and above producing placebo effects) and that they can in some cases actually be dangerous. Furthermore, the spurious reasoning of CAM supporters is exposed for what it is, and their dubious tactics to try to silence Ernst are put under the spotlight.

The book is first and foremost a memoir. Even those of us who have long followed Ernst’s research may well find a few surprises here. Ernst was born into a poor family in Germany just after World War II. His mother, described as “a most determined and in many ways an endearingly eccentric woman,” was an enthusiastic user of alternative medicine, and thus the young Ernst never questioned whether or not such treatments actually had any real therapeutic value or not. He simply accepted that they did work (for all the reasons that will be familiar to regular readers of this magazine).

Ernst’s first passion in life was not science; it was music—specifically jazz. He admits to being rather lazy (and at times rebellious) at school, and as a young man was much more interested in listening to and playing jazz and generally having a good time than studying. Fortunately, his mother gently pushed him in the direction of applying himself in order to get into medical school, assuring him that it would provide him with a solid profession to fall back on “if you ever get fed up with making music.”

If you were to assume that entering medical school provided the spark that ignited Ernst’s passion for science, you would be wrong. In common with many medical students, he found that the essential requirement to master vast amounts of factual material completely precluded any time for reflection, much less the application of critical thinking.

After six gruelling years at medical school, Ernst eventually qualified as a “real doctor” and got his first job—in Germany’s only homeopathic hospital. He admits to actually knowing next to nothing about homeopathy when he took up the post (homeopathy had rightly been dismissed as nonsense by his professor of pharmacology at medical school). He read up on homeopathy and quickly realized that it had absolutely no plausible scientific basis—and yet he saw on a daily basis that many patients appeared to benefit from it. When he asked the medical director at the hospital what caused this improvement in their patients, he was surprised by the candid reply: “It’s mostly due to the fact that we discontinue all the useless medications they had been taking previously.”

Ernst was employed in many different and varied medical institutions over the following years in Germany and Austria, but it was not until he took up a post at St. George’s Hospital in London that he truly became passionate about research, albeit in the field of blood rheology as opposed to CAM. He found being immersed in the world of scientific research exhilarating, especially the pervasiveness of critical thinking. However, he was to take up several more posts before finally landing the position that was to bring him to the attention of most readers of this magazine. Each of these appointments, in one way or another, prepared him for what was to be his final appointment before retirement.

It was in September 1993 that Ernst arrived in England, with his ever-supportive French wife, Danielle, to take up an exciting new post as the Laing Chair in Complementary Medicine at the University of Exeter. Both were already devoted Anglophiles by this time, not least because they had met and fallen in love in England many years earlier. It seems to me that the good professor has a very British sense of humor that shines through in this book. He does not believe in the rigid hierarchies based upon authority that characterized some of the continental institutions in which he had worked but instead engages in constant questioning (and sometimes gentle ridicule) of sacred cows of all kinds.

As such it should come as no surprise that he did not quite behave as many people expected him to after taking up his post in Exeter. He was committed to carrying out high-quality research into the efficacy and safety of CAM, not simply promoting its use in an uncritical manner. This admirable attitude won him much respect in the eyes of fellow scientists and the wider skeptical community. Ernst and his team published literally hundreds of papers during his time at Exeter, attracting huge interest from the media and doing vast amounts in terms of educating the wider public about the true nature of CAM.

However, his approach also won him many powerful enemies among supporters of CAM—most notably Prince Charles and his followers. In time, there were also those in positions of power at the University of Exeter whose fear of offending the British royal family led them to take steps to silence Ernst’s entirely valid criticisms of CAM. Eventually, his unit was run down and he was, after almost two decades, eased out of his post.

I am pleased to say that this has not had the desired effect of silencing Professor Ernst as this book shows. Long may this man speak truth unto power!

In the pages of the Skeptical Inquirer and elsewhere in the skeptical literature, you can read about a seemingly endless array of snake oil remedies, dubious health claims, questionable practices, ineffective regulation, and shortcomings of mainstream medicine. All of this is happening in an era of so-called “evidence-based medicine,” which was supposed to rededicate the medical profession to a solid scientific grounding in order to bring the best possible care to each patient.

Don’t get me wrong: modern medicine is a science-based endeavor. We continue to make tremendous, even accelerating, progress in understanding and treating disease. The institutions of science and the professionalism within medicine are also improving over time. The evidence-based medicine (EBM) movement has been, overall, a positive influence on the practice of medicine. EBM had two main goals: to evaluate and systematically characterize the evidence base for each clinical decision, and to deliver this information to practitioners when and where they need it. EBM is great as far as it goes, but it has some interesting flaws, and clearly has not done enough to eradicate pseudoscience and substandard practice from medicine.

That is exactly why I founded the website Science-Based Medicine, which has recently spawned the Society for Science-Based Medicine group (headed by Mark Crislip).

The goal of science-based medicine (SBM) is to raise the practice of medicine to the highest standards possible, relying on the full spectrum of scientific evidence; raising the application of critical thinking to the practice of medicine; optimizing the institutions of science, research, and academia; rooting out pseudoscience and quackery; and advocating for effective regulations.

Science-Based Medicine vs. Evidence-Based Medicine

The core weakness of evidence-based medicine is that it relies, as the name implies, solely on clinical evidence to determine whether a treatment is appropriate or not. This may superficially sound reasonable, but it deliberately leaves out an important part of the scientific evidence: plausibility.

When EBM was first proposed, the idea was that doctors should not be using treatments simply because they make sense. We need evidence to show that the treatments are actually safe and effective. This is reasonable, but their solution was to eliminate “making sense” (or plausibility) from the equation. Each treatment was considered conceptually as a blank slate or with a level playing field—the only thing that mattered was the clinical evidence.

Unfortunately, the EBM movement came at roughly the same time that dubious health practices were being rebranded as “complementary and alternative medicine” (CAM). By leveling the playing field, EBM inadvertently removed the primary objection to most CAM modalities: that they are highly implausible. I guess it did not occur to early EBM proponents that anyone would seriously propose a highly implausible treatment and try to study it scientifically. CAM proponents fell in love with EBM, because it gave them the opportunity to present their treatments with a veneer of scientific legitimacy. They tend to interpret EBM as meaning that if you can point to any evidence whatsoever (no matter how poor and conflicting), then you can call your practice “evidence-based.”

One of the standard bearers for EBM is the Cochrane Collaboration, which publishes high-quality systematic reviews of clinical questions. Cochrane reviews quickly became ripe for CAM exploitation. My favorite example is a Cochrane review of homeopathic substance Oscillococcinum for the flu (Vickers and Smith 2009). Oscillococcinum is imaginary, and homeopathy is utter nonsense, so this treatment is akin to fairy dust diluted out of existence. If anything should be treated as having a prior plausibility of zero, this is it. Yet the authors concluded:

Though promising, the data were not strong enough to make a general recommendation to use Oscillococcinum for first-line treatment of influenza and influenza-like syndromes. Further research is warranted but the required sample sizes are large. Current evidence does not support a preventative effect of Oscillococcinum-like homeopathic medicines in influenza and influenza-like syndromes. (Vickers and Smith 2009)

While they are essentially saying that the evidence is negative, they characterize the treatment as “promising” and recommend “further research.” SBM would take a different approach.

A science-based medicine review would explicitly consider prior scientific plausibility, bringing to bear our understanding of physics, chemistry, and biology, which represent a far larger and more reliable body of scientific evidence than the few clinical studies of Oscillococcinum. It would also consider the totality of homeopathy research in the context of our current understanding of patterns of evidence in the medical literature.

An SBM review would conclude that the scientific basis for the existence of Oscillococcinum is unconvincing to say the least, and actually is rank pseudoscience analogous with N-rays. Homeopathy itself also qualifies as pseudoscience, because it is at odds with our basic understanding of physics and chemistry. Furthermore, the totality of the homeopathy clinical research is most consistent with a treatment that has no effect.

We therefore have an ineffective application of a nonexistent substance. Further, there is no scientific reason to presume that this particularly treatment will be effective for the flu. Finally, the clinical evidence is insufficient (unsurprisingly) to conclude that the treatment works. Taken as a whole it seems that this treatment has no promise and any further research would be such a waste of resources as to be unethical.

Prior Plausibility

It is not surprising that advocates of dubious health treatments do not like the concept of plausibility. They have been basking in the sun of EBM where they don’t have to answer for extreme scientific implausibility and resent SBM trying to ruin their good time.

This attitude is represented by an opinion piece by David Katz, in which he writes:

This essay makes the case that such borders are not readily defined and challenges policy makers and practitioners with this question: In which direction lies the greater risk of miscarriage for legitimate scientific inquiry and the promise of improving the human condition—in the belief that something works whether or not it’s plausible, or in the conviction that something is implausible whether or not it works? (Katz 2010)

Katz and other CAM advocates try to present plausibility as a mere bias, one that will turn us away from effective treatment. Katz completely misses the point—plausibility is partly how we know if something works. CAM advocates tend to start with the conviction that their treatments work, and are trying to find scientific justification to help them market their treatment. I have yet to find a single example of a CAM modality that was abandoned by its advocates due to evidence of lack of efficacy.

SBM recognizes that clinical evidence is tricky, complicated, and often ambiguous. There is good evidence to support this position. John Ioannidis has published a series of papers looking at patterns in the clinical research. He found that most published studies actually come to what is ultimately the wrong conclusion, with a strong false-positive bias (Ioannidis 2005). This effect is worsened in proportion to the implausibility of the clinical question.

Simmons et al. nicely demonstrated that by exploiting common researcher “degrees of freedom,” that almost any set of data can be made to seem statistically significant (Simmons et al. 2011). In other words, it is possible to manipulate the data, even completely innocently, just by making decisions about how to collect and analyze the data that can achieve a falsely statistically significant result. Individual studies, therefore, should rarely be compelling. Data is only truly reliable when it is independently replicated, especially in a way that eliminates the degrees of freedom.

In a commentary for Nature, Regina Nuzzo describes what is called “p-hacking,” which is essentially what Simmons et al. were also describing (Nuzzo 2014). Nuzzo is specifically criticizing over-reliance on P-values, which is the statistical measure of whether or not data is significant and should be taken seriously. P-values, however, are not as reliable as many assume.

A P-value of 0.01, which many falsely believe to mean that the effect being studied has a 99 percent chance of being real, only has a 50 percent chance of being replicated with fresh data. So even a value that many take as solid evidence is really only a coin flip when you properly understand the statistics. The problem of over-reliance on P-values is further demonstrated by statistician Geof Cummings in a video he posted on YouTube (Cummings 2009).

One solution to the weaknesses of P-values is to supplement or even replace this type of statistical analysis with another type of analysis called Bayesian analysis. Bayesian analysis formally considers prior plausibility. It looks at the data as common sense dictates: How much does this new data affect the prior probability that a specific scientific idea is true?

Conclusion

The core philosophy of SBM is to use the best possible conclusion that science currently has to offer in making clinical decisions (including regulatory ones). This includes the most rigorous clinical studies possible. However, it must also consider preclinical and basic science—all scientific information that can reasonably be applied to the question at hand. This means considering the overall scientific plausibility of any clinical claim.

Clinical evidence faces many challenges, including researcher bias, publication bias, and the vagaries of statistical analysis. Most studies that are performed are imperfect; for example they may be too small, may not sufficiently account for all variables, may have defects in blinding, and have to make many choices (such as which outcomes to measure and compare), that can affect the outcome. (For more discussion on these points, see Morton E. Tavel, “Bias in Reporting of Medical Research,” in this issue, p. 34.)

It often takes decades for clinical research to progress to the point that we have highly rigorous and definitive trials. In the meantime, we have to make decisions based upon imperfect evidence. Basic science plausibility helps put the clinical evidence into context, improving our ability to make reliable decisions based upon preliminary clinical data. That is why I believe that evidence-based medicine should evolve in the direction of science-based medicine. That would be the evidence-based thing to do.

References

Cummings, G. 2009. Dance of the P-Values. Online at https://www.youtube.com/watch?v=ez4DgdurRPg.

Ioannidis, J. 2005. Why most published research findings are false. PLoS Medicine 2(8) (August): e124. Doi: 10.1371/journal.pmed.0020124 PMCID: PMC1182327.

Katz, D. 2010. Descartes’ carton–On plausibility. Explore 6(5) (September/October).

Nuzzo, R. 2014. Scientific method: Statistical errors P values, the ‘gold standard’ of statistical validity, are not as reliable as many scientists assume. Nature News (February 12).

Simmons, Joseph P., Leif D. Nelson, and Uri Simonsohn. 2011. False-positive psychology: Undisclosed flexibility in data collection and analysis allows presenting anything as significant. Psychological Science Doi: 10.1177/0956797611417632.

Vickers, A., and C. Smith. 2009. Withdrawn: Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes. Cochrane Database Systematic Review (July 8), (3):CD001957. Doi: 10.1002/14651858.CD001957.pub4.

Dr. Paul Offit, director of the Vaccine Education Center and chief of the Division of Infectious Diseases at Children’s Hospital in Philadelphia, is one of the world’s leading proponents of vaccinations and good public health practices. His book Deadly Choices was subtitled “How the Anti-Vaccination Movement Threatens Us All.” He’s also author of Do You Believe in Magic? The Sense and Nonsense of Alternative Medicine and most recently (March 10) Bad Faith: When Religious Belief Undermines Modern Medicine. In an interview with Lindsay Beyerstein on the Center for Inquiry Point of Inquiry podcast, Offit spoke about the early 2015 measles outbreak at Disneyland, the anti-vaccination movement, and the importance of vaccination.

Photo: J. Kyle Keener for USA TODAY

Lindsay Beyerstein: Let’s talk about the flu vaccine this year. What happened with it?

Dr. Paul Offit: I would say we’re generally pretty good at figuring out what strands are about to circulate, and we do that usually a few months before we make the vaccine. We predicted basically what’s circulating in South America because usually that’s what comes up here and that was what was circulating. The problem is that one of the strands, the H3N2 strand, mutated enough away from what the vaccine strand was so that protective efficacy this year was woeful. It was in the 23 percent range, which is terrible. I don’t remember a year like this actually, since I started to follow this for the last twenty years. This, I think, is the worst year we’ve had for protective efficacy in my memory.

Beyerstein: How do you calculate protective efficacy?

Offit: You look at people who got the vaccine and those who didn’t, then you look at the infection rate of those who got the vaccine and those who didn’t, and then you can figure out what the efficacy was. If 25 percent of people in the non-vaccinated group got sick and then only 2 percent of the vaccinated group got sick, the protective efficacy is about 90 percent.

Beyerstein: What is herd immunity, and what kind of vaccination rate do we need to sustain to keep herd immunity strong for measles?

Offit: Herd immunity just means that enough people are vaccinated in the population so that the virus or the bacteria has a lot of trouble spreading from one person to the next because so many people are vaccinated. In terms of the level of herd immunity that’s necessary, it depends on the nature and contagiousness of the virus or bacteria you’re trying to prevent. For these highly contagious viruses like measles, mumps, or chicken pox, you really need to have between 92 and 94 percent of the population immunized in order to prevent that spread.

For diseases that are less contagious, you don’t need as high of a percentage because what happens is when herd immunity starts to fade, you see exactly what you’re seeing now—which is the most contagious diseases come back first: measles, mumps, whooping cough. It’s just what you would expect.

Beyerstein: A lot of people put their children at risk for religion. It seems like it’s perfectly compatible with a lot of religious beliefs. There are people who recruit their children to be suicide bombers.

Offit: I don’t know why. If you look, for example, at the followers of religions such as Christian Scientists, often these things are done in the name of Jesus, and I don’t get that. I’m not a religious person but if one reads the New Testament, you can’t help but be impressed by the figure described as Jesus. “Verily, I say unto you, what you do unto the least of my brethren, you do unto me.” You put that on the entrance of every children’s hospital in the world. This is a man who stood up for children at a time when infanticide was common, when abandonment was common, when child abuse was the crime embraced by the Roman Empire. You could argue independent of whether you believe in God or you believe Jesus was the son of God, the way Jesus is described in the New Testament he is a breakthrough character in terms of his defense of children. I don’t get it.

Beyerstein: He also was pro-healing, and he never said you shouldn’t have any healing except for me.

Offit: That’s right. When you’re sick, go to the doctor. In three of the four gospels that made it into the New Testament, that’s what he says. I don’t get it. What bothers me is when we had that outbreak in Philadelphia, it would have been nice for somebody who represented the church to stand up and say, “This is nuts. This is a distinctly un-Christian thing to do.” That would have helped. I think our respect for religion is great to a point, but this is that point.

Beyerstein: Many of the anti-vaccination parents are well educated and affluent. Why do you think that they’re such fertile ground for these crazy ideas?

Offit: I think they don’t fear the disease. I think it’s that simple. I think in Southern California, you’re living this wealthy, upper middle class, upper-class environment. You’re eating well, you’re exercising. You don’t see this disease so you think this is not going to happen to me, until it happens to you. That’s the way it always works with these diseases.

Beyerstein: There is this group that you’ve identified as the vaccine hesitant parents, and you said that they have a big role to play in improving public health outcomes for vaccinations. Who are they and what can we do to get them on our side?

Offit: I think that’s most people. We talk about the anti-vaccine movement, but the true anti-vaccine movement are the professionals—Barbara Loe Fisher at National Vaccine Information Center or J.B. Hanley at Generation Rescue, or people like Jenny McCarthy—but some are conspiracy theorists. They believe that there is a conspiracy between or among the federal government and the pharmaceutical industry and doctors to sort of push product, but you’re not going to convince them. I think that’s not most people.

Most people, there’s just an anti-vaccine sentiment. They don’t see the disease; they’re not scared of the disease; they’ve read scary stuff on the Internet. They’re not sure what they should do. I think those people are, for the most part, convincible. I think we just have to be a little more compelling in the way we try and convince them.

Beyerstein: Are people more friendly toward, say, polio vaccinations because they know that polio means paralysis? I get the sense that people are less likely to want to refuse that than a measles vaccine or a diphtheria vaccine, or pertussis, that they don’t even know what the disease really is.

Offit: It’s interesting, isn’t it? People are hesitant to get an HPV vaccine, human papilloma virus vaccine, to prevent a disease that causes twenty-five thousand cases of cancer, four thousand deaths a year. Yet, they’re happy to get a polio vaccine. We haven’t had a case of polio in the United States since 1979. You’re right. I think we’re not very good at judging risk.

Beyerstein: There was an op-ed in USA Today recently that was arguing that parents who refuse to vaccinate for mandatory vaccines should be jailed. Do you think that is acceptable or necessary?

Offit: No, I think that goes too far. We have three ways that you can choose not to get a vaccine in this country and one is a medical exemption. I think that’s fine. I think this so-called personal belief exemption is nonsensical. Vaccines aren’t a belief system. They’re an evidence-based system. There’s abundant evidence that shows they are what they claim to be. Again, I think a religious exemption is also nonsensical because it’s an unreligious act. So don’t give it the legal protections of religion. The notion that you’re allowing people to put children at risk in the name of religion is, I think, averse to all, frankly, religions. I just wish we’d be more honest about this. If people choose not to get vaccinated it’s because they’re not scared of the disease, and they have false concerns about what the vaccine can do. That’s what this is all about, so don’t make it so easy for them to exempt themselves.

Beyerstein: Who would you say are the biggest players in the anti-vaccine movement now, if you’re looking at the people who are responsible for the sad state of vaccine public opinion?

Offit: I think it was the National Vaccine Information Center. They were born in the early 1980s. At the time, they were called “Dissatisfied Parents Together,” or DPT. They were concerned that the wholesale pertussis vaccine, which was used then—pertussis being whooping cough—caused permanent brain damage, which was absolutely not true. It was shown in many studies not to be true. It’s been more than thirty years and that kind of launched the notion that vaccines may be doing more harm than good. It’s interesting, if you look at the measles outbreak in Southern California, a number of those people are over twenty. I think those are the first generation of children born of that sort of anti-vaccine sentiment of the early 1980s. . . . I definitely think that the anti-vaccine movement is losing ground. I think that the media have got far more responsible about covering this story. If you look at the way it was covered fifteen years ago, it was always this false mantra of balance, which is tell two sides of the story when only one side is supported by the science. . . . I think the media are much more responsible about this either because younger journalists are being trained in perspective and not false balance, or because the outbreaks are so egregious that you can’t help but feel the choice not to get a vaccine was a bad one.

Beyerstein: If you’re a parent and you’re concerned about vaccination levels at your kid’s school, what can you do to change that to help protect people?

Offit: I think that you can attend a PTA meeting say, “Look, I think we should all care about each other. We all are responsible for each other.” When a Jehovah’s Witness, for example, chooses not to get a blood transfusion when they have a life-threatening loss of blood, they’ve made a decision for themselves and themselves only. They can’t make that decision for the child. But you can make that decision for yourself, fine, that’s fine. It doesn’t affect anybody else. When you choose not to get a vaccine, that’s a different story. Now you are saying, “It’s my right to spread a potentially fatal infection.”

This piece is adapted from a transcript of the February 2, 2015, Point of Inquiry podcast. The full interview can be heard at http://www.pointofinquiry.org/paul_offit_md_on_measles_in_the_magic_kingdom_and_the_anti-vaccine_movement/.

When Skeptical Inquirer asked me to report on a skeptical conference happening in my backyard of San Francisco, I was, well, skeptical. I’ve been attending and occasionally speaking at skeptics’ conferences for the past decade, and with that investment of time in a relatively tiny subculture, one tends to see the same “big ticket” speakers over and over again, to the point that in case of a skeptical disaster I’m fairly certain I could fill in for at least half of them if given their PowerPoint presentations and a reasonably convincing bald cap/mustache combo.

So, I was pleased to note that the 2015 SkeptiCal line-up contained no speakers I had ever seen before. It’s a bold strategy for an organization to take, but it clearly paid off for SkeptiCal since not only was the program entertaining, but the venue appeared to be sold out.

The conference was held in the lovely Oakland Asian Cultural Center, which was easily accessible by BART, car, or bike. Oakland’s Chinatown is a great neighborhood with a lot of delicious lunch and dinner options, and the Cultural Center itself had a steady stream of adorable children taking classes. What could be better?

photo by Susan Gerbic

The day started with Dr. Peggy Lemaux of the Department of Plant and Microbial Biology at UC Berkeley, speaking about the use of genetically modified (GM) crops. While it was a mostly basic overview of the importance of GM research, I learned a few things. For instance, I tend to think of the public as being mostly distrustful of GM, but Lemaux pointed to the success of some SUNY researchers who developed a blight-resistant version of the nearly extinct American chestnut tree and relied on crowd-funding to begin a restoration project to plant 10,000 new trees. Their Fundly project raised $10,000, twice what they were originally asking for.

Lemaux’s talk was also refreshing in that she didn’t hesitate to share some of her concerns with GM, such as an overreliance on Roundup Ready crops. Too often, people who speak up for GM whitewash their concerns for fear that anti-GM activists will take them out of context. It’s an understandable fear, but if the public is truly to trust scientists, they need to understand that science is messy and full of healthy disagreement.

photo by Susan Gerbic

Periodically, SkeptiCal had breakout sessions. For the first, I saw Kenzi Amodei of the Center for Applied Rationality give a talk titled Your Inner Simulator: How to integrate logic and intuition. I’ll be honest, I was expecting for this talk to be full of pseudoscience, considering that the description asserted that humans’ logical reasoning “evolved independently” from our intuitive reasoning, which seemed like a gross oversimplification at best. The actual talk, though, was simply a good overview of dual process theory and focused primarily on how people can use the theory to improve their ability to meet goals. I enjoyed it until Amodei announced that we would be splitting into groups to practice using the techniques she described to achieve our own goals. As the nice man next to me turned to introduce himself, I panicked and apologized, saying I had to go. I am deathly allergic to audience participation workshops.

I ran to the other hall, where the audience sat silently in darkness watching videos while Ron Hipschman of the Exploritorium explained the science behind science-fictional ideas like teleportation. It was exactly what I needed.

Next up was astrophysicist Dr. Natalie Batalha, Mission Scientist for NASA's Kepler Mission. Kepler is the space observatory which has thus far discovered more than 1,000 Earth-like planets orbiting other stars in our galaxy. Batalha covered the techniques used for identifying those planets based on the data available—information that may be familiar to those who are already fascinated by the search, but Batalha’s passion and intelligence on the topic was inspiring to hear, and anyone in the room who wasn’t already invested probably left with a new curiosity for the important work that Kepler is doing.

Batalha also had a great method for putting into perspective the search for habitable life in our universe: imagine the entire universe is only the size of the United States, and our conference was Earth. The best chance of finding live in the universe would be within ten light years, or in this analogy, a few city blocks away. Lord knows what’s happening over in New Jersey.

Ann Reid was next on the schedule. She’s currently most well-known in the skeptics’ world for taking over the National Center for Science Education (NCSE). She had big shoes to fill, considering that Eugenie Scott was NCSE’s previous director and over the years became well-known for being sharp, tenacious, and extremely charming. I’m happy to report that NCSE has developed some kind of cloning technology, since Reid appeared to demonstrate all of Scott’s best traits as she spoke about her area of expertise: viruses. Reid was instrumental in the sequencing of the 1918 influenza virus, and as such had a lot to say about how viruses mutate, what people panic about with no reason, what we should panic about, and why vaccines are incredibly important.

Another breakout session followed, during which I had to choose between Isil Arican discussing international skepticism or Frank Mosher conducting a “workshop for producing skeptical children.” Considering my personal avoidance of workshops in general, I certainly wasn’t up for attending one where the audience interaction would be focused on producing children (of any kind), so unfortunately I had to skip that one.

photo by Susan Gerbic

Arican gave an overview of the work of well-known international skeptics such as Indian rationalist Sanal Edamaruku and Nigerian humanist Leo Igwe. The interesting part of her talk concerned her own area of expertise, though: skeptical activism in Turkey, where a common phrase is “don’t bring new ways to the old village” and the Minister of Science and Technology once went on record to say, “We should train more pastry chefs instead of physicists.” I’m not one to disparage a good pastry, but that doesn’t seem to bode well for Turkey’s future scientific achievements.

Arican also described a particular fortune-telling method I’d never heard before. Apparently, in Turkey one can get their fortune told by holding a bowl of water on their head and dropping molten lead into it to see what shapes form when the lead cools. Unfortunately, many of the accurate fortunes go something like this: “You’re going to drip molten lead on your face.” I’ve since learned the practice isn’t restricted to Turkey, and elsewhere is known as Molybdomancy.

The final speaker was Dr. John Ioannidis, Professor of Health Research and Policy at Stanford University best known for his research on why so much published scientific research is wrong. This was a particularly relevant talk considering that it came just days after the discovery that a well-publicized Science paper was a fraud.

Ioannidis gave a thorough overview of the main problems with the current peer review system, and then ended his talk with his suggested solution, which essentially involves a complete overhaul of the culture behind scientific publishing. In large part Ionnidis blames the way the system rewards scientists for publishing large breakthroughs, and not for producing small, quantifiable, and reproducible results. He’s given his reengineered reward system the acronym PQRST:

Productivity
Quality
Reproducibility
Sharing of data
Translational impact

He asserts that if this reward system replaces the current system, it will all but eliminate the problem of research being published that is simply wrong. It’s an interesting idea, and one I’ll talk a bit more about in a future post.

SkeptiCal ended the day with a magician, Robert Strong. Strong is a capable performer who is keeping alive the unstated rule that every skeptics’ conference must have at least one person on stage who can complete a 4x4 magic square.

All in all, it was a fantastic conference and I look forward to next year’s line-up. If you’re anywhere nearby, I recommend getting tickets and meeting some of the Bay Area’s best and brightest scientists and skeptics.

I think everyone would agree that it would not be a good idea to put pesticides in a saltshaker and add them to our food at the table. But there is little agreement when it comes to their use in agriculture. How much gets into our food? What are the effects on our health or in the environment? Is there a safer alternative?

Where should we look to find science-based answers to those questions? One place we should not look is books written by biased nonscientists to advance their personal agendas. A friend recently sent me a prime example of such a book: Myths of Safe Pesticides by André Leu, an organic farmer whose opinions preceded his research and whose bias is revealed in the very title.

The Foreword and Introduction: A Bad First Impression

The Foreword to Leu’s book is by Dr. Vandana Shiva, an environmentalist who blames Monsanto’s GMO seeds and pesticides for causing 284,000 Indian farmers to commit suicide since 1995, a claim that is almost certainly false (Kloor 2014). She says pesticides don’t even work in the first place: the brand Roundup is failing to control weeds and is creating superweeds, and “pesticides create pests.” She is an alarmist who cites the Bhopal tragedy and Rachel Carson’s Silent Spring. She says Leu’s book synthesizes the scientific evidence of pesticides’ harm to public health and provides evidence that pesticide-free alternatives are more productive.

Leu does collect a lot of evidence for the harms of pesticides, but he doesn’t balance it with other evidence of benefits and safety. And his evidence for pesticide-free alternatives is far from convincing.

His Introduction begins with his personal observation of “so much illness in our communities, especially cancers, behavioral disorders, and degenerative diseases” and with his personal testimonial of getting sick every spraying season even though no sprays are used on his farm. He set out to find evidence to validate his belief that pesticides were responsible. Predictably, confirmation bias kicked right in and had a field day.

His bias even interferes with his reading comprehension. He says the US President’s Cancer Panel report “clearly states that environmental toxins, including chemicals used in farming, are the main cause of cancers” [emphasis added] (President’s Cancer Panel 2010). In fact it states no such thing! It says “the true burden of environmentally induced cancer has been grossly underestimated [at 6%],” and even that statement has been challenged by the American Cancer Society, whose representative said the panel restated hypotheses as facts and its conclusion does not represent scientific consensus (Nelson 2010). Tobacco causes 30 percent of all U.S. cancer deaths and another 30 percent are attributed to diet, obesity, and physical inactivity; and there are many other causes of cancer including alcohol, sun exposure, radon, medical radiation, infections, and occupational exposures. Pesticides are low on the list.

The Five ‘Myths’

After finding such obvious errors in the Foreword and Introduction, I was tempted to drop the book in the wastepaper basket, but I persevered. Leu proceeds to address five “myths” in five chapters:

1. All agricultural poisons are scientifically tested to ensure safe use.

2. The residues are too low to cause any problems.

3. Modern pesticides rapidly degrade. 4. Regulatory authorities are reliable and trustworthy.

5. Pesticides are essential to farming.

“Myth” 1: All Agricultural Poisons Are Scientifically Tested to Ensure Safe Use.

Note the inflammatory choice of words: “poisons” rather than pesticides. It is true that many chemicals in use in the United States have not been adequately tested for safety, but even he himself admits that pesticides have been studied more than most other chemicals. Leu cites several of those studies. For instance, one study found 232 chemicals in the cord blood of newborns; some of those chemicals can harm brain development and the nervous system, but they have never been found to do so in the amounts detected. He criticizes current scientific testing methods as unsound and points out that the developing fetus may have special needs. Pesticide exposure has been linked to a number of health problems in children, including lower IQs, autism, ADHD, lack of physical coordination, loss of temper, bipolar illness, schizophrenia, and depression. These are reported correlations, not proven causations. He cites birth defects and gene alterations in mice exposed to pesticides, but there is no comparable evidence for humans. I agree that these studies are cause for concern and further research, but I think it is premature to draw firm conclusions or use that evidence to guide public policy.

“Myth” 2: The Residues Are Too Low to Cause Any Problems.

Leu says the lowest doses of some chemicals can be more toxic because they begin to act as hormones at those low levels. My colleagues and I have looked into endocrine disruptors and written about them on the Science-Based Medicine blog (Lipson 2009; Hall 2009; Hall 2011; Novella 2008); we were not particularly worried by what we found. Leu reproduces graphs showing increasing rates of diabetes, obesity, and thyroid cancer, and implies that endocrine disruptors are a major cause. He has a whole section on cell receptors that doesn’t make sense; he tries to tell us that “key” molecules can only fit into the “lock” receptors when they are present in small numbers(!?). Yes, there are legitimate concerns about hormone disruption, but so far it’s all hypotheses and no reliable conclusions. If there is any effect, it is small in magnitude.

“Myth” 3: Modern Pesticides Rapidly Degrade.

Dioxins are very persistent in the environment, and they can contaminate food. Pesticides can degrade into other chemical compounds that are harmful. Testing is not done on every possible pesticide and metabolite. Washing and peeling produce can reduce pesticide residues but can’t eliminate them. He says the bulk of pesticides are inside the food, but that is only true for systemic pesticides that are absorbed by the plant and circulated through its tissues; other pesticides remain on the plant’s surface and can be washed off or removed by peeling. For that matter, 99.99 percent of all the pesticides in our diet are natural components of the food—pesticides that plants produce naturally to protect themselves and that can’t be eliminated (Ames 1990). Any synthetic pesticide residue is a drop in the bucket compared to the much larger concentrations of natural plant pesticides.

“Myth” 4: Regulatory Authorities Are Reliable and Trustworthy.

Leu doesn’t trust authorities. He says, “History shows that regulatory authorities have consistently failed to prevent the contamination of the environment and human health by products previously designated safe, such as asbestos, lead, mercury, dioxins, PCBs, DDT, dieldrin, and other persistent organic pollutants.”

That’s horribly one-sided and unfair. He could have cited some of the many, many successes of government regulation in protecting public health and the environment; some of those successes involve the very contaminants he lists. He faults the government for continuing to allow mercury in fillings and vaccines, not acknowledging that mercury is no longer used in any vaccine except for the multidose injectable flu vaccine, and that there has never been any evidence of danger from the use of mercury in vaccines or fillings. He points out variations in regulations between different countries, and his simplistic explanation is “politics,” whereas I think it is clearly more complicated than that.

Leu particularly targets glyphosate, showing nine graphs with correlations between glyphosate, GMOs, and everything from diabetes to intestinal infection. Apparently he thinks correlation means causation; it doesn’t. He doesn’t seem to know about that now-famous graph showing an almost perfect correlation between autism and organic food.

“Myth” 5: Pesticides Are Essential to Farming.

Leu cites a number of studies where organic farming practices produced greater yields than conventional methods. He shows evidence that organic crops are more resilient in adverse conditions like droughts, and that good practice organic systems produce higher yields in traditional small farm settings.

Recent advances in organic farming techniques are very encouraging, and anything that reduces the need for pesticides sounds like a good idea. But it remains to be seen whether the techniques can be implemented everywhere, whether “industrialized” large-scale organic farming can adopt them, and whether they are really the most practical way to increase yields and improve safety. It may be possible for farmers to eschew pesticides, but is it feasible on a large scale? Is it really preferable to judicious use of pesticides following best practices and evidence-based guidelines? Those are questions that science will be able to answer, but the necessary studies have not been done yet.

Some Facts and Balances

How much pesticide residue is actually present on our foods? The Pesticide Data Program of the USDA has been asking that question for twenty-two years now. In 2012, they sampled nearly 12,000 foods and found that residues were below EPA tolerance levels in over 99 percent. They concluded that “residues found in agricultural products sampled are at levels that do not pose risk to consumers’ health (i.e., are safe according to EPA)” (USDA 2014). The World Health Organization and other organizations around the world are also monitoring pesticide residues and establishing tolerance levels, and there are international databases.

The obvious next question is how safe levels are determined. The EPA sets those levels and their website explains how they arrive at them (EPA 2007). They don’t just make stuff up; they go by evidence and expert reasoning. Levels change as new evidence warrants it. The system isn’t perfect, but it’s reasonably good. A perfect system would be prohibitively expensive if not impossible to carry out to Leu’s satisfaction.

One activist organization reports that eighty-six pesticides were found on cucumbers. That might sound scary, but what does it really mean? Modern analysis can find tiny trace amounts of lots of things, but remember the old adage “The poison is in the dose.” We know, for instance, that organophosphate pesticides are toxic and workers must take precautions, but we also know that ingesting one single molecule of even the most deadly poison will not result in any detectable harm. There is a legitimate concern that ingesting multiple chemicals at safe levels might add up to unsafe cumulative effects, and that infants and pregnant women might be at higher risk. This doesn’t mean we should reject all pesticides on the precautionary principle; it only means more studies should be done.

It’s important to put the harms of artificial pesticides into context. As Bruce Ames has pointed out:

Carrots, celery, parsley, parsnips, mushrooms, cabbage, Brussels sprouts, mustard, basil, fennel, orange and grapefruit juices, pepper, cauliflower, broccoli, raspberry, and pineapple contain natural pesticides that cause cancer in rats or mice and that are present at levels ranging from 70 ppb (parts per billion) to 4 million ppb-levels that are enormously higher than the amounts of man-made pesticide residues in plant foods. (Ames 1989)

Any discussion of harms from pesticides should weigh the harms against the benefits. There certainly are benefits: pesticides have increased crop yields and helped humans in other ways (EPA 2012):

• Pesticides are the only effective means of controlling disease organisms, weeds, or insect pests in many circumstances.

• Consumers receive direct benefits from pesticides through wider selections and lower prices for food and clothing.

• Pesticides protect private, public, and commercial dwellings from structural damage associated with termite infestations.

• Pesticides contribute to enhanced human health by preventing disease outbreaks through the control of rodent and insect populations.

• Pesticides are used to sanitize our drinking and recreational water.

• Pesticides are used to disinfect indoor areas (e.g., kitchens, operating rooms, nursing homes) as well as dental and surgical instruments.

• The pesticide industry also provides benefits to society. For instance, local communities and state governments may be partially dependent upon the jobs and tax bases that pesticide manufacturers, distributors, dealers, commercial applicators, and farmers provide.

Incidentally, when plants are not exposed to artificial pesticides they tend to increase their production of natural pesticides. This phenomenon has not been well studied. The “natural” pesticides allowed in organic farming have not been studied anywhere nearly as thoroughly as the artificial ones. It is a fallacy to assume they are safer just because they are natural.

The news about health effects of pesticides is not all bad. A review of the literature concluded:

When compared to the general population total mortality has been found to be consistently lower among pesticide manufacturers as well as among other groups of workers. This observation has been mostly attributed to the “healthy worker effect” or, in the case of agricultural workers, to the healthier lifestyle of farm families. With the exception of deaths by accidental causes, non-cancer causes of death (mainly represented by cardiovascular diseases), were generally found to be less frequent than expected among manufacturers or users of pesticides, in particular among farmers. No consistent evidence of global cancer mortality different from that of the general population has been reported among pesticide manufacturers or applicators. On the other hand, the papers examined have been strikingly consistent in reporting a low overall cancer risk among agricultural workers; life-style, clean air, low prevalence of smoking have been hypothesized so as to explain this observation. (Maroni and Fait 1993)

Conclusion

Pesticides are meant to harm weeds and insects, but are they also harming us? Leu demonizes pesticides as “poisons” and argues that the precautionary principle should make us eliminate their use entirely. I think he exaggerates the dangers, especially considering that evolution has equipped the human body to thrive while eating foods with levels of natural pesticides several orders of magnitude greater than the levels of artificial pesticides in today’s foods. I certainly agree with him that there is a need for more research. He says safe pesticides are a myth, but I have to wonder if any evidence of safety would ever satisfy him; he seems to be demanding “perfect” safety like some anti-vaccine activists do. There is a danger to invoking the precautionary principle before ensuring that the alternatives are not worse.

This is what typically happens when a layman with an ax to grind ventures into the scientific arena looking for evidence to support his prior beliefs. A good scientist would look just as carefully for any evidence that might prove his hypothesis wrong. Leu’s book stands in stark contrast to another book by a layman, Matt Fitzgerald, Diet Cults: The Surprising Fallacy at the Core of Nutrition Fads and a Guide to Healthy Eating for the Rest of Us. Unusually for a layman, Fitzgerald understands science better than many of the doctors who have written about nutrition. He approached his subject without bias, looked at the literature on both sides, and came to eminently reasonable conclusions. I reviewed his excellent book on the Science-Based Medicine blog (Hall 2014).

Leu’s book is useful, but only as a handy compilation of things we ought to be thinking about—things that scientists are already addressing.

Note

This article was originally published on the Science-Based Medicine blog on December 9, 2014 (www.sciencebasedmedicine.org/pesticides-just-how-bad-are-they/).

References

Ames, B. 1989. Danger, Natural Pesticides. Online at http://www.fortfreedom.org/s42.htm.

———. 1990. Dietary pesticides (99.99% all natural). Proceedings of the National Academy of Sciences 87: 7777–7781. Online at http://www.pnas.org/content/87/19/7777.full.pdf.

EPA. 2007. Assessing Health Risks from Pesticides. Online at http://www.epa.gov/pesticides/factsheets/riskassess.htm.

———. 2012. Benefits of Pesticide Use. Online at http://www.epa.gov/oecaagct/ag101/pestbenefits.html.

Hall, H. 2009. “The disappearing male”—A pinch of science, a pound of speculation. Online at http://www.sciencebasedmedicine.org/the-disappearing-male-a-pinch-of-science-a-pound-of-speculation/.

———. 2011. Phthalates and BPA: Of mice and men. Online at http://www.sciencebasedmedicine.org/phthalates-and-bpa-of-mice-and-men/.

———. 2014. Diet cults vs. science-based healthy eating. Online at http://www.sciencebasedmedicine.org/diet-cults-vs-science-based-healthy-eating/.

Kloor, K. 2014. The GMO-suicide myth. Online at http://blogs.discovermagazine.com/collideascape/files/2014/01/GMOsuicidemyth.pdf.

Lipson, P. 2009. Endocrine disruptors—the one true cause? Online at http://www.sciencebasedmedicine.org/endocrine-disruptors-the-one-true-cause/.

Maroni, M., and A. Fait. 1993. Health effects in man from long-term exposure to pesticides. A review of the 1975-1991 literature. Toxicology 78(1–3):1–180.

Nelson, R. 2010. President’s Cancer Panel: Environmental Cancer Risk Underestimated. Online at http://www.medscape.com/viewarticle/721766.

Novella, S. 2008. Bisphenol A in plastics: Should we worry? Online at http://www.sciencebasedmedicine.org/bisphenol-a-in-plastics-should-we-worry/.

President’s Cancer Panel. 2010. Reducing Environmental Cancer Risk. Online at http://deainfo.nci.nih.gov/advisory/pcp/annualReports/pcp08-09rpt/PCP_Report_08-09_508.pdf.

USDA. 2014. Pesticide Data Program. Online at http://www.ams.usda.gov/AMSv1.0/getfile?dDocName=stelprdc5106521.

Today’s Brain Teaser Question: What product….

1. Was inspired by its co-creator’s experience with the Alzheimer’s disease of both of his grandmothers?^[1]
2. Has attracted $70 million dollars in venture capital investments?^[2]
3. Has 50 million subscribers?^[3]
4. Had, as of February 2013, achieved $23.6 million in revenue?^[4]
5. Claims to be serious training for your brain that can improve memory, attention, and other cognitive abilities through the “science of neuroplasticity”?
6. But, according to a consensus statement signed by seventy neuroscientists and memory researchers, lacks any “compelling evidence” that the product offers consumers “a scientifically grounded avenue to reduce or reverse cognitive decline”?^[5]

Answer: (You guessed it.) Lumosity. It is clear that much of that $70 million in investments has gone into advertising because almost everyone has heard of Lumosity and understands its basic claims. Unfortunately, far fewer people know what the research really tells us about Lumosity.

The Brain Training Promise

As the population ages, concerns about Alzheimer’s disease and dementia have created a demand for anything that might stave off the course of mental decline. The idea that simple video games on your computer or smartphone could keep you mentally sharp is very appealing. Furthermore, brain training programs have a kind of simple plausibility. They sound scientific, and the analogy to physical exercise makes intuitive sense.

In addition, Attention Deficit Hyperactivity Disorder (ADHD) continues to be a concern for parents of school-aged children, and memory and attention training programs designed for children with ADHD have emerged to meet the need.

Lumosity appears to be the market leader in this brain training stampede, but it is by no means the only brain game in town. Here are just a few of the other products in this lively marketplace.

Lumosity has kept its claims relatively modest, but its competitor brainHQ, a division of Posit Science, Inc., is less restrained. The brainHQ website claims this collection of online games can “improve your tennis game” and help you “hear better in crowded places.” Most importantly they assert that brainHQ “turns back the clock on your memory loss by about 10 years.”^[6]

CogniFit appears to be very similar to Lumosity and brainHQ but with a less elaborate website and advertising campaign.

Developed by Swedish researcher Torkel Klingberg and now owned by the publishing giant Pearson, Cogmed has a very different marketing approach. Lumosity and brainHQ sell subscriptions to their online games directly to the end user, but Cogmed is marketed through a network of professional providers. This approach makes sense because, although the program is for all ages, Cogmed makes a special effort to pitch its product to parents of children with ADHD. The Cogmed website features a video testimonial by Dr. Edward Hallowell, psychiatrist and author of the popular book Driven to Distraction.

Jungle Memory is a subscription memory program specifically for children, marketed directly to parents. It claims to be effective with kids who suffer from ADHD, dyslexia, autism spectrum disorders, motor dyspraxia, and learning difficulties. Like all the other brain training products, Jungle Memory comes complete with many testimonials and claims to be based on “cutting-edge science.”

The Pseudoscience Behind Brain Training

If you have been following this industry at all, you may have heard that the brain training claims are not supported by evidence. In April 2013, New Yorker writer Gareth Cook published a scathing review of CogMed called “Brain Games are Bogus,” and last autumn, the consensus statement mentioned above, a collaborative project of the Stanford Center on Longevity and the Max Planck Institute on Human Development, received some media coverage.^[7]

But the pushback on these programs has not received the kind of attention it deserves, and media coverage written by people who have swallowed the industry public relations line is still common. For example, “The Silver Economy: Brain training fired up by hard evidence,” an article published last autumn in the Financial Times appeared after the consensus statement was released and made reference to the consensus statement, but still presented a favorable image of the brain training industry.

As is often the case, the problem lies in the inability of journalists^[8] and the general public to determine what constitutes “hard evidence.” Lumosity tends to keep their claims relatively vague. They point to ongoing research at their own Lumos Labs, but much of the research is either not peer reviewed or not relevant to the question of whether Lumosity actually works. For example, a recent Lumos Labs publication in the peer-reviewed journal Frontiers in Human Neuroscience simply outlines the research potential of the enormous dataset Lumosity has collected from its subscribers.^[9]

In contrast to Lumosity, brainHQ’s claims are whoopers. For example, the brainHQ website says, “We know it cuts your risk of crashing your car in half,” but the research cited in support of this claim is not a study of brain training at all. It is a study of car crashes among older drivers that finds a relationship between neurological disease and car accidents.^[10]

So, no, you don’t know that brainHQ cuts the risk of car crashes. Or if you do, you are using the word “know” in a much different way than I do.

The IMPACT Study

On the surface, the study that supplies the foundation of brainHQ’s most important claim to “turn back the clock on your memory loss,” as well as other claims that the brain game system fights depression and “improves health-related quality of life measures for five years,” sounds pretty impressive. The “IMPACT study” was conducted in part at the Mayo Clinic and published in the Journal of the American Geriatric Society in 2009. However the conflict of interest statement accompanying the article indicates that the study was funded by brainHQ’s parent company, Posit Science, Inc. and that five of the seven authors had some kind of financial relationship with Posit Science.

Perhaps most troubling, the study methodology did not eliminate the possibility of experimenter bias because the person who installed the software for the participants and introduced them to its use was not blind to the study design.^[11] Even so, the results just made it over the bar for statistical significance (p = .02) and the size of the observed effect—the practical or clinical significance of the study—was less than a quarter of a standard deviation (d = 0.23) or what is generally considered a weak effect.^[12] Not the most impressive of outcomes.

The ACTIVE Study

A more recent study that impressed the Financial Times writer as being “hard evidence,” is the “ACTIVE study” published in 2014 in the same Journal of the American Geriatric Society. It was a large-scale multi-site clinical trial supported by grants from the U.S. National Institute on Aging and the National Institute of Nursing Research. In this case, the two lead investigators had financial interests in products used in the research. However, the most damning feature of the study was that almost all the positive effects that were observed were changes in self-report measures. In other words, participants believed they had improved and reported belief to the investigators. In contrast, the objective measures—actual tests of functioning—produced much more mixed results. Importantly, the objective measures of problem solving and memory functioning showed no significant effect.^[13]

The Portal 2 Study—Just for Fun

To make matters worse, a 2014 Florida State University study published in Computers & Education, suggests that you would be better off playing the popular first-person video game Portal 2 than playing Lumosity’s brain games. In this case, the researchers recruited college students and randomly assigned them to play either eight hours of Portal 2 or eight hours of Lumosity in a laboratory setting over a series of sessions. Before and after training, both groups were given a battery of objective tests of problem solving, spatial ability, and persistence.

Surprise!

The group who played Portal 2—which makes no claims about any cognitive benefits—scored significantly better than the Lumosity group on all three measures. Furthermore, the effect sizes were double those of the IMPACT and ACTIVE studies. The Lumosity group showed no significant difference pre-versus-post on any measure.^[14]

Like any study, this one has strengths and weaknesses. The experimenters statistically controlled for the participant’s level of enjoyment of the game, and, as a result, the outcome cannot be dismissed solely on the assumption that Portal 2 is more fun to play than Lumosity. But the sample was relatively small (N = 77) and made up entirely of college students. Furthermore, because the post-test measures were completed shortly after the last game session, it is impossible to know how long the effects would last.

So What’s The Harm?

The purveyors of the “science of neuroplasticity” have clearly oversold their goods. But how bad can it be? The games are harmless and sometimes even fun. Because the typical brain training business model is to sell modestly priced subscriptions (approximately $150-$240 per year) to a large client base, the financial loss for any particular individual is not great. Although at this point, there is little evidence that playing computer games (except perhaps Portal 2!) produces cognitive and memory gains that transfer to everyday life, perhaps someday more effective programs will be developed. So what’s the harm?

I can think of two ways this brain training episode causes harm:

Opportunity Costs

The most important harm for the individual user is what economists call opportunity costs. Making one choice eliminates the opportunity to do something else. As the authors of the consensus statement make clear, for people who want to preserve their cognitive capacity, sitting at a computer for several hours a week may not be the best choice:

If an hour spent doing solo software drills is an hour not spent hiking, learning Italian, making a new recipe, or playing with your grandchildren, it may not be worth it. But if it replaces time spent in a sedentary state, like watching television, the choice may make more sense for you.^[15]

The message is clear. Based on the available evidence, playing brain games on the computer is probably not the best way to maintain cognitive health. It is better to get up and do something more active with your life. The authors of the consensus statement put it this way:

…the promise of a magic bullet detracts from the best evidence to date, which is that cognitive health in old age reflects the long-term effects of healthy, engaged lifestyles.

The Misuse of Science

In recent years, science has been battered by a number of self-inflicted wounds—fraud and sloppy or absent peer review. But pseudoscience, the unearned use of the trappings of science to bolster a claim (in this case, a product claim) has been with us a long time. As soon as science achieved a level of stature, people began hijacking scientific language for their own purposes.

Today, neuroscience has created a great boon for the purveyors of pseudoscientific products, because, as sciences go, it has a lot of trappings. Neuroscience is concerned with our most mysterious organ, the brain, and it makes use of elaborate equipment, technical language, and colorful images. (To learn more about the misuses of neuroscience, see Brainwashed: The Seductive Appeal of Mindless Neuroscience by Sally Satel and Scott O. Lilienfeld.)

To be sure, neuroscience is a wonderful and exciting field, but like many shiny new things, its benefits have been overstated. In this case, neuroscience has become the indentured servant of an industry whose products may be all but useless. The brain training programs that are currently available are potentially quite lucrative for their makers but a waste of time and money for most users.

To protect the integrity of the science, it is important for science-minded people to call out pseudoscience when they see it, and it is hard to think of a more dramatic case of contemporary pseudoscience than the brain training industry. Because brain training programs are not drugs, they do not fall under Food and Drug Administration standards of proof of effectiveness. Brain training companies are subject to the truth in advertising standards of the Federal Trade Commission, but somehow, they seem to have avoided prosecution while spinning tales of improved tennis games, better memory, and safer driving. So it is up to individual scientists, journalists, and science advocates to speak up about the brain training scam. No one else is going to do it.

After that, you can go back to playing Portal 2.

^[1] http://blog.lumosity.com/the-lumosity-story-video/

^[2] http://techcrunch.com/2012/08/22/lumosity-raises-31-5m-from-discovery-communications-for-brain-fitness-games/

^[3] http://www.lumosity.com/press/releases/lumosity-reaches-50-million-members-and-1-1-billion-game-plays

^[4] http://www.forbes.com/companies/lumosity/

^[5] http://longevity3.stanford.edu/blog/2014/10/15/the-consensus-on-the-brain-training-industry-from-the-scientific-community-2/

^[6] http://blog.brainhq.com/2010/10/27/giving-health-advice-for-older-people-dont-forget-the-brain/

^[7] http://chronicle.com/article/Brain-Training-Companies-Get/149555/, http://www.scientificamerican.com/article/brain-training-doesn-t-make-you-smarter/

^[8] As an aside: I have come to believe that all science journalists should have a PhD in a science. Figuring out the scientific claims of both scientists and non-scientists requires some fairly serious training. Interviewing scientists is not a sufficient methodology for getting to the bottom of some questions.

^[9] Sternberg, D. A., Ballard, K., Hardy, J. L., Katz, B., Doraiswamy, P. M., and Scanlon, M. (2013). The largest human cognitive performance dataset reveals insights into the effects of lifestyle factors and aging. Frontiers in Human Neuroscience, 7, 292. doi:10.3389/fnhum.2013.00292

^[10] http://www.ncbi.nlm.nih.gov/pubmed/10719769

^[11] Smith, G. E., Housen, P., Yaffe, K., Ruff, R., Kennison, R. F., Mahncke, H. W., & Zelinski, E. M. (2009). A Cognitive Training Program Based on Principles of Brain Plasticity: Results from the Improvement in Memory with Plasticity-based Adaptive Cognitive Training (IMPACT) Study. Journal of the American Geriatrics Society, 57(4), 594–603. doi:10.1111/j.1532-5415.2008.02167.x

^[12] https://en.wikipedia.org/wiki/Effect_size#Cohen.27s_d

^[13] http://onlinelibrary.wiley.com/doi/10.1111/jgs.12607/abstract

^[14] Shute, V. J., Ventura, M., & Ke, F. (2015). The power of play: The effects of Portal 2 and Lumosity on cognitive and noncognitive skills. Computers & Education. doi:10.1016/j.compedu.2014.08.013

^[15] http://longevity3.stanford.edu/blog/2014/10/15/the-consensus-on-the-brain-training-industry-from-the-scientific-community-2/

A Disgraceful Contempt for Evidence-Based Medicine

Despite the increasing global recognition of the value of evidence-based medicine, the World Health Organization (WHO) still appears to be on a quest to promote the integration of consistently unproven and irrational therapies (quackery) into medicine worldwide. In a shameful recent advertising supplement in Science, fully sponsored by two Chinese universities, Margaret Chan, director-general of the WHO, calls once again for integrating traditional medicine (TM) with scientific medicine:

For many millions of people, often living in rural areas within developing countries, herbal medicines, traditional treatments, and traditional practitioners are the main—and sometimes the only—source of health care. The affordability of most traditional medicines makes them all the more attractive at a time of soaring health care costs and widespread austerity. . . . In wealthy countries, TM meets an additional set of needs. People increasingly seek natural products and want to have more control over their health. They turn to TM to relieve common symptoms, improve their quality of life, and protect against illness and diseases in a holistic, nonspecialized way. (Chan 2014)

The typical logical fallacies commonly displayed by pro-alternative supporters are flagrantly apparent in her discourse; we can recognize the naturalistic fallacy, argument from popularity, argument from antiquity, etc. Worse, her words imply that any reasonable quality standards for health care can be disregarded for the poor. This corresponds to nothing less than double standards in global health care. Her statements are a painful illustration of the course the WHO has taken since 2002 and can be seen as a follow up on the publication of the WHO TM Strategy 2014-2023 earlier last year. This strategic document, which like the Science supplement was financially supported by China, urgently needs our attention as it prioritizes political preference and commercial value of an important Chinese export product over the advancement of global health.

(For more on the Science TCM supplement, see David Gorski’s article in this issue, p. 46.)

Reinvigorating a Traditional Strategy

At the start of 2014, the WHO reinvigorated its strategy to boost the use of TM, nine years after its previous strategy report expired. In the new report WHO TM Strategy 2014-2023, the WHO persistently entangles the definitions of TM and “complementary and alternative medicine” (CM), including botanical medicine (World Health Organization 2013). CM includes all kinds of unproven therapies such as acupuncture, homeopathy, chiropractic, and anthroposophic therapy. This strategy follows the Declaration of Alma Ata (World Health Organization 1978) that positioned the traditional healers within the primary health care and the previous WHO TM Strategy 2002-2005 (World Health Organization 2002). The current renewal of the strategy is the result of a resolution accepted by the World Health Assembly (WHA) in 2009, stating that an update of its predecessor was timely. This WHA resolution (WHA62.13), it says, demands the adoption, implementation, and integration of T&CM (WHO’s eclectic collection of traditional and alternative therapies together under one umbrella) into the health system of the member states “where appropriate, based on safety, efficacy, and quality.” The resolution urges the WHO to assist the member states in this process as much as possible.

Margaret Chan, director-general of the World Health Organization, has called for integrating traditional medicine with scientific medicine. (Photo: ALEXANDRE GELEBART/SIPA)

The resulting WHO TM strategy report that was published last year was mainly inspired by China and sponsored by the Chinese government, a major exporter of traditional remedies, and its contents were predictable. Without demonstrating any awareness of the virtually complete absence of evidence for both TM and CM, the strategy defines its own goals as “harnessing” the contribution of T&CM to health care and “promoting the safe and effective use of T&CM by the member states.” According to the new strategy, member states experience difficulties with respect to the development of policy and regulations of T&CM, the integration of T&CM in the national health systems, assessment of safety of products and practitioners, research and development, and the sharing of information between countries. The report gives some statistical data regarding the increasing popularity of CM in developed countries and stresses the cheapness of TM in developing countries as a major advantage, forgetting that much T&CM is far from cheap and, more important, that comparing costs without evaluating efficacy can lead to absurd recommendations. The selection of references shows a strong pro-T&CM preference and uncritical appraisal. Critical papers demonstrating the decline and the lack of scientific support for CM are systematically neglected (Shang et al. 2005). After many decades of research on this issue (for example by the NIH’s National Center for Complementary and Alternative Medicine, which spent almost $2 billion on this matter), no convincing evidence to support the practice of any CM has been found (Mielczarek and Engler 2012), except for a few botanical products now justifiably incorporated into conventional medicine. Critical and robust science regarding the proof of efficacy of TM is very rare and the outlook for this branch of medicinal folklore is bleak. Politically touted praise for TM by the WHA and the demand for mutual respect between traditional healers and medical doctors are not in the interest of global health and are outdated. The EU rules on safety and efficacy of medication have led to the disappearance of thousands of traditional remedies from pharmacies. Should they be reinstated? Is the WHO really advancing global health by promoting both TM and CM?

Traditional and Complementary Medicine: Any Common Ground?

The actual definition of T&CM in the WHO’s report is so vague that it could be used for almost any form of therapy, product, diagnostic, therapeutic procedure, or ritual, as long as there is no convincing proof for its efficacy. There is actually little “traditional” about all the Western CM therapies. The currently prevailing alternative therapies have only in the last few decades gained popularity in Western countries over the more traditional therapies such as traditional herbal therapy, magnetizing, and naturopathy. These have nearly vanished, which in itself certainly has to be considered as progress, but they have been replaced by more modern CM therapies, such as those we have mentioned. The adjective “complementary” in “complementary medicine” implies that it has added value or improves the regular medicine to which it is added. This is deceptive phrasing, because it remains unclear what unproven alternative therapies such as homeopathy and anthroposophic medicine, essentially “quack” therapies that have been widely criticized, can add to regular medicine. In well-designed randomized clinical trials, the efficacy of CM therapies could not be established. More importantly, their underlying theories are incompatible with current scientific ideas at large, and thus there is no rationale for these therapies (Puustinen 2014; The Lancet Editors 2005). They are not always harmless; at best they only delay any effective treatment and leave the patient with an absurd concept of pathophysiology and disease. The report claims, but does not prove, that CM has great value in prevention or health maintenance. The anti-vaccination attitude among homeopaths, anthroposophists, and chiropractors points in a completely different direction (Carillo-Santisteve and Lopalco 2012). If any “complementary” therapy would be effective and exhibit therapeutic value, by the rules of evidence-based medicine, it would of course have been incorporated into regular medicine and the prefix “complementary” would no longer be adequate.

Traveling Together

Traditional medicine, such as that practiced in Asia and Africa, consists of a mixed bag of therapies (e.g., plant-, animal-, spiritual-, and energy-based). Some of these traditional therapies have a rational theoretical base, but most of them do not. The same holds for the CM therapies, with a possible exception for some elements of manipulative therapy. As we have described, there are actually few similarities between the various TM and CM therapies. But the adherents of TM and CM found each other through a shared problem: they both remain unsupported by scientific evidence and are not generally accepted in the world of evidence-based medicine. Therefore, they travel together and misuse the numerical majority in the WHA to gain acceptance by political means.

Curiously, the focus of the WHO TM Strategy is neither toward rigid proof of efficacy of the mixed bag of therapies nor toward access to effective therapy but seems to be aimed at the financial and intellectual property (IP) aspects: commercialization, reimbursement, and protection of IP. For China, the Chinese TM therapies are a hugely important export product worth $3.14 billion in 2013 (Ying 2014). The Chinese government clearly seeks recognition and legitimacy of these traditional therapies. It wants to claim they have efficacy, safety, and quality so it can export even more of them. But a lack of proven efficacy and guaranteed safety has limited the possibilities of approval through the conventional medical regulatory authorities (Jia 2011). China is therefore circumventing the regular medicine legislation and is actively seeking other “marks” of quality, such as ISO certification of their products (International Organization for Standardization 2012). The financial support of the present WHO TM Strategy report might be another lobby effort of China for its export product.

Advancing Global Health?

While the lack of access to quality health care in many parts of the world is evident and requires urgent action from WHO member states, in our opinion the proposed strategy for increasing the rollout and strength of T&CM as proposed in the recent WHO strategy will only aggravate the situation. The universal right to health demands universal access to good quality health care and medicines of proven efficacy. Whether or not a therapy is of good quality should be assessed by the rules of evidence-based medicine and confirmed by good-quality clinical trials. The report advocates “real world experiments,” without explaining what that means. This expression was invented by vendors of therapies that failed the objective tests of randomized clinical trials. They try to gain acceptance based on testimonies, or “anecdotal evidence,” which obviously does not equal proof of efficacy. Promoting a treatment solely based on satisfaction or popularity, without comparisons to a control group, will not bring the goal of access to efficacious treatments for all any closer.

Most Western complementary therapies (e.g., homeopathy) have already been extensively proven to be ineffective and should immediately be abandoned. Promising traditional therapies, which are compatible with established medical knowledge, need more extensive and rigid clinical evaluation before being promoted or regulated. However, evaluation of T&CM could become a never-ending story since most of these therapies do not have generally accepted rules or procedures, and individual therapists each practice their own version. Assumed safety, solely based on many years of use, is unacceptable and can in fact be life threatening, as illustrated by the Chinese nephropathy tragedy (De Broe 2012) and well-documented cases of heavy metal poisonings by Indian Ayurvedic products (Lynch and Braithwaite 2005; Saper et al. 2004). The correct order of procedures should be: register and define, evaluate, recognize, regulate, but integrate only after convincing proof of safety and efficacy. The WHO should not support and promote acceptance of non-evidence-based therapies based solely on popularity and tradition, not in rich countries and not in poor countries. It is unethical to integrate therapies in a national health-care system before convincing proof of efficacy and safety is provided.

The role of traditional healers in advancing global health might be to have them assist and become involved in the spread of regular evidence-based care and access to essential medicines. In that process, practitioners of proven medicine will gradually replace any unproven therapies and practices. It is a missed opportunity that the WHO TM Strategy does not describe this scenario and by doing so impedes effective health care for underprivileged patients in resource-poor regions. We regard this as a disgraceful example of political choices in an area that should be dominated by science.

References

Carrillo-Santisteve, P., and P.L. Lopalco. 2012. Measles still spreads in Europe: Who is responsible for the failure to vaccinate? Clinical Microbiology and Infection 18 (Suppl 5): 50–6.

Chan, M. 2014. Supporting the integration and modernization of traditional medicine. Science 346 (6216 Suppl): S2.

De Broe, M.E. 2012. Chinese herbs nephropathy and Balkan endemic nephropathy: Toward a single entity, aristolochic acid nephropathy. Kidney International 81(6): 513–5.

Gorski, D.H. 2015. Science sells out: Advertising traditional Chinese medicine in three supplements. Skeptical Inquirer 39(3) (May/June): 46–48.

International Organization for Standardization. 2012. Business plan ISO/TC 249 Traditional Chinese Medicine “Provisional.” Online at http://isotc.iso.org/livelink/livelink/fetch/2000/2122/687806/ISO_TC_249__Traditional_chinese_medicine_.pdf?nodeid=14482951&vernum=-2. Last accessed January 20, 2015.

Jia, H. 2011. Traditional Chinese medicines hampered by EU regulations. Chemistry World (June 10). Online at http://www.rsc.org/chemistryworld/News/2011/June/10061102.asp. Last accessed January 20, 2015.

Lynch, E., and R. Braithwaite. 2005. A review of the clinical and toxicological aspects of “traditional” (herbal) medicines adulterated with heavy metals. Expert Opinion on Drug Safety 4(4): 769–78.

Mielczarek, E., and B. Engler. 2012. Measuring mythology: Startling concepts in NCCAM grants. Skeptical Inquirer 36(1): 35–43.

Puustinen, R. 2014. From physical bodies to astral bodies—theoretical problems in anthroposophic medicine. Focus on Alternative and Complementary Therapies 19(1):22–6.

Saper, R.B., S.N. Kales, J. Paquin, et al. 2004. Heavy metal content of ayurvedic herbal medicine products. The Journal of the American Medical Association 292(23): 2868–73.

Shang, A., K. Huwiler-Müntener, L. Nartey, et al. 2005. Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. The Lancet 366(9487): 726–32.

The Lancet Editors. 2005. The end of homoeopathy. The Lancet 366(9487): 690.

World Health Organization (WHO). 1978. Declaration of Alma Ata. Online at http://www.who.int/publications/almaata_declaration_en.pdf. Last accessed January 20, 2015.

———. 2002. WHO Traditional Medicine Strategy 2002-2005: Geneva, Switzerland. Online at http://whqlibdoc.who.int/hq/2002/WHO_EDM_TRM_2002.1.pdf. Last accessed January 20, 2015.

———. 2013. WHO Traditional Medicine Strategy 2014-2023: Geneva, Switzerland. Online at http://whqlibdoc.who.int/hq/2002/WHO_EDM_TRM_2002.1.pdf. Last accessed January 20, 2015.

Ying, Y. 2014. Pharmaceutical industry needs shot of innovation. China Daily (February 11). Online at http://www.chinadaily.com.cn/business/2014-02/11/content_17276108.htm. Last accessed January 20, 2015.

While “Food Babe” Vani Hari’s pseudoscience has been widely debunked by qualified doctors and scientists, a more sobering fact seems to have escaped everyone’s attention: one of America’s most notorious bloggers is earning sales commissions from products that contain the very same ingredients she says are dangerous.

Vani Hari, the "Food Babe," is neither a scientist nor a nutritionist.

Vani Hari (the “Food Babe”) has built quite a following for herself since her 2011 debut, with nearly one million followers on Facebook and a new book release in February 2015. While Hari’s pseudoscience has been widely debunked by qualified scientists (e.g., Crislip 2013, Gorski 2014), a more sobering fact seems to have escaped everyone’s attention: one of America’s most notorious bloggers is earning sales commissions from products that contain the very same ingredients she says are dangerous. Ironically, for a web activist who seems to do most of her research via Google, the evidence is only a few mouse clicks away. In her article “Throw This Out of Your Bathroom Cabinet Immediately,” Hari links aluminum in modern deodorants to horrific diseases such as breast cancer and Alzheimer’s (Hari 2013b). But in that same piece she recommends—and earns an Amazon.com affiliate commission from—Naturally Fresh deodorant, which contains ammonium alum and potassium alum (Naturally Fresh 2015). It’s perplexing that Hari didn’t take one additional step and look up these two compounds while writing her blog. She would have found they’re better known as ammonium aluminum disulfate dodecahydrate and aluminum potassium sulfate (U.S. National Library of Medicine 2015a; 2015b). Yes, after warning about the dangers of aluminum in deodorants, Ms. Hari earns a commission on a deodorant that contains . . . aluminum.

Is this just a one-off mistake, poor research, or the use of scare tactics to sell competing products? You be the judge: In “The Ingredients in Sunscreen Destroying Your Health,” Food Babe warns that applying vitamin A (retinyl palmitate) to your skin and going out in the sun puts one in danger of skin cancer (Hari 2013a). Yet she brings in affiliate dollars on skin care products that contain vitamin A, such as Tarte Blush. Affiliate links on FoodBabe.com lead the buyer to web pages that proudly proclaim retinyl palmitate among the ingredients (Tarte Cosmetics 2015a).

Screen shot from the "Food Babe" Vani Hari's website.

The vitamin A/skin cancer scare has already been debunked by experts (e.g., Wang et al. 2010), but that’s beside the point. Hari makes the claim that vitamin A in skin care products is dangerous, yet she’s profiting from the sales of such a product.

On that note . . . what does Food Babe recommend in a sunscreen? According to her, a must-have ingredient is titanium dioxide (TiO₂), and she provides a list of “acceptable” TiO₂-laden lotions (with the ever-present affiliate links). This is hypocritical; one of the Babe’s most vocal and infamous campaigns has been against Starbucks for their use of a particular caramel coloring in spiced pumpkin lattes (Hari 2014). According to Hari, the coloring contains 4-Methylimidazole (“4-Mel”), classified as a group 2B carcinogen by the International Agency for Research on Cancer (IARC). Do you know what else is listed as a group 2B carcinogen? Titanium dioxide: her “gotta have” sunscreen ingredient (International Agency for Research on Cancer 2014).

For perspective, also on the IARC list are coffee, pickled vegetables, talc body powder, and the professions of carpentry and firefighting. But—relative safety of the additives aside—why is it okay to use scare tactics to frighten consumers away from a product then turn around and earn commissions on others in the same group? Food Babe identifies the IARC as the source for her 4-Mel cancer claim, so how did she miss the titanium dioxide? It’s on the same list. Does the fact that she’s helping sell products that contain TiO₂ have any bearing on her research?

Vani Hari's "takedown" of the Starbucks pumpkin spice latte criticizes the use of a 2B carcinogen similar to the one found in her "gotta have" sunscreen.

Tim Berners-Lee invented the World Wide Web in 1989 as a research tool, and it can be powerful when used correctly. I’m not sure he imagined how badly it could be abused by “investigators” such as Vani Hari, who seem to give up the chase after a single mouse click. In “Be a Drug Store Beauty Drop Out!,” she declares women must avoid beauty products with ingredients ending in “-siloxane” because they’re supposed endocrine disruptors (Hari 2011a). Later, in an article for Well & Good magazine, she gushes about “Tarte Cosmetics Lights Camera Lashes Mascara” (Hari 2012). Not coincidentally, she earns a sales commission on this mascara. One more click of the mouse would have told her that it contains cyclopentasiloxane (Tarte Cosmetics 2015b). If you noticed that cyclopentasiloxane ends in “-siloxane” (the supposed endocrine disruptor), then congratulations: you’ve done more research than Food Babe.

What do leukemia, hummus, and facial cleansing milk have in common? In the world of Vani Hari, quite a lot, apparently. Every night before going to bed, she washes her face in Avalon Organics Facial Cleansing Milk (Hari 2011b). Three months after she divulged this beauty secret, Hari solemnly warned her readers that packaged hummus was dangerous because it could contain: “Potassium Sorbate . . . known to cause skin allergies with prolonged use” and “Sodium Benzoate . . . when combined with Vitamin C . . . can produce benzene that has been known to cause Leukemia and other cancers” (Hari 2011c).

You’ve probably guessed by now what can be found in Food Babe’s facial cleansing milk: potassium sorbate, sodium benzoate, and lemon peel—a rich source of vitamin C (Avalon Organics 2015). If these ingredients cause skin allergies and leukemia as Hari claims, why is she promoting them via her website?

These are just a few examples of products recommended by Food Babe that contain exactly the same ingredients she claims are dangerous. Catching her in the act is as simple as picking an additive from her “ban” list (Alsip 2014) and reading the label on an item she recommends. It’s important to stress that experts in science and medicine have time and again debunked Hari’s claims that the ingredients discussed in this piece are as dangerous as she claims. No one should walk away in fear of buying any of the products discussed here.

The takeaway message is that Hari’s science is as questionable as her investigative techniques. When given a taste of her own medicine—using a simple web browser to look up the ingredients of items she recommends—Food Babe’s role as a safety advocate is cast in a new light. The fact that she openly earns sales commissions on products pushed via her website should give us all pause for thought.

References

Alsip, Mark. 2014. The Food Babe ban list (blog entry). Online at https://badscidebunked.wordpress.com/2014/12/17/the-food-babe-ban-list/.

Avalon Organics. 2015. COQ10 Repair Facial Cleansing Milk (product page). Online at http://avalonorganics.com/coq10-repair-facial-cleansing-milk.

Crislip, Mark. 2013. Scam stud (blog entry). Online at http://www.sciencebasedmedicine.org/scam-stud/.

Gorski, David. 2014. Vani Hari (a.k.a. The Food Babe): The Jenny McCarthy of food (blog entry). Online at http://www.sciencebasedmedicine.org/vani-hari-a-k-a-the-food-babe-the-jenny-mccarthy-of-food/.

Hari, Vani. 2011a. Be a drug store beauty drop out! (blog entry). Online at http://foodbabe.com/2011/07/31/how-to-find-safe-beauty-products/.

———. 2011b. So fresh and so clean (blog entry). Online at http://foodbabe.com/2011/08/09/so-fresh-and-so-clean-skin-care-tips/.

———. 2011c. Why aren’t you making your own hummus? (blog entry). Online at http://foodbabe.com/2011/05/18/homemade-hummus/.

———. 2012. Well & Good: My five beauty obsessions (blog entry). Online at http://wellandgood.com/2012/10/30/my-five-beauty-obsessions-vani-hari/.

———. 2013a. The ingredients in sunscreen destroying your health (blog entry). Online at http://foodbabe.com/2013/05/05/what-you-need-to-know-before-you-ever-buy-sunscreen-again/.

———. 2013b. Throw this out of your bathroom cabinet immediately (blog entry). Online at http://foodbabe.com/2013/04/10/throw-this-out-of-your-bathroom-cabinet-immediately/.

———. 2014. Drink Starbucks? Wake up and smell the chemicals! (blog entry). Online at http://foodbabe.com/2014/09/02/drink-starbucks-wake-up-and-smell-the-chemicals/.

International Agency for Research on Cancer. 2014. Agents Classified by the IARC Monographs, Volumes 1–111. Online at http://monographs.iarc.fr/ENG/Classification/ClassificationsGroupOrder.pdf.

Naturally Fresh. 2015. Naturally Fresh (product page). Online at http://www.amazon.com/gp/product/B005P0WRLU/.

Tarte Cosmetics. 2015a. Tarte Blush (product page). Online at http://tartecosmetics.com/skinvigorating-ingredients#/ and http://tartecosmetics.com/tarte-shop-vitamins-a-c-e/.

———. 2015b. Tarte Cosmetics Lights Camera Lashes Mascara (product page). Online at http://www.amazon.com/gp/product/B002XOQSPC/.

U.S. National Library of Medicine/PubChem. 2015a. Ammonia Alum. Online at https://pubchem.ncbi.nlm.nih.gov/compound/62668/.

———. 2015b. Potassium Alum. Online at https://pubchem.ncbi.nlm.nih.gov/compound/24856/.

Wang, S., S. Dusza, and H. Lim. 2010. Safety of retinyl palmitate in sunscreens: A critical analysis. Journal of the American Academy of Dermatology 63(5): 903–906.

When my friend Ross and I started a podcast about investigating weird stuff five years ago, we didn’t know what kind of investigation requests we would get. There were the obvious ones: Scientology, ear candling, 9/11 Truthers, oil pulling. What we didn’t expect was one request that cropped up repeatedly: essential oils.

My understanding of essentially oils was essentially (sorry) that they were concentrated versions of various smelly things: lavender, eucalyptus, rose. And that aromatherapy enthusiasts used different smells to evoke different emotions or mental states. But aromatherapy turns out to be only a small part of the essential oils movement. And to find out exactly what it entails, my cohost Ross and I joined a one-night class called “Essential Oils Have Amazing Benefits!”

Ross and I live in Los Angeles, and the event was in Rolling Hills Estates, a small affluent community about thirty miles away. The chiropractor playing hostess had a small shop on the upper level of an outdoor mall, complete with a Pottery Barn and a Starbucks, though the whole mall was dead by the time we arrived at 7 pm. We climbed the escalator to the shop and entered a small, bare waiting room where a few chairs and a table had been set up for the class. At the front of the room was a table on which dozens of oils and oil mixtures were displayed, accompanied by signs that touted their benefits: some were for allergies, digestion, energy, healthy skin, and the all-encompassing “total wellness.”

“Welcome!” said Lucy,* the chiropractor who had offered her office up for the session. “Just sign in here, and we’ll get going.”

The room smelled of lavender. Along one side of the hall leading to the treatment rooms was a table covered in healthy vegetarian treats. We loaded up on hummus, carrots, and crackers and sat down among the other students. As the room filled and finally evened out at twelve attendees, it became apparent that essential oils are a female-dominated vocation. Of the twelve people, two were male: Ross and a little boy “forced” there by his mom.

Alice,* the woman leading the class (which might also be called a sales pitch) was a “Wellness Advocate” for doTERRA, one of the leading essential oils companies. Headquartered in Utah, doTERRA has “advocates” all across the country who sell oils out of their own homes and businesses. Much like Scentsy or Mary Kay (or, back in the day, Tupperware), advocates make money from selling the oils at profit or by signing up friends to become advocates themselves. If we chose to become Wellness Advocates, we were told, we would be wise to purchase a $550 starting kit. According to 2014 data, the most common sales level earns a seller about $25,500 a year.

As we went around the circle listing our names and reasons for attending, many women shared that they were new to the essential oils world. Even Marie,* who was assisting Alice with the presentation, had only been in the business for one month.

“My husband is a big skeptic, so when I gave him oils the first time, he didn’t believe it, but now he asks me all the time, ‘What have you got for this or that?’”

Ross and I looked at each other pointedly, wondering whether her husband was just getting this oil stuff out of the way rather than hearing about it all afternoon while he suffered through a headache.

“Now, I’m a lawyer,” said Alice, “And we have to tell you, essential oils don’t treat or cure anything. They just work with your body’s natural ability to heal itself.”

This sort of hedging is common in alternative medicine circles. Words and terms such as helps, works with, aids, and complements hint at the idea that the alternative medicine isn’t doing the heavy lifting. This cleverly avoids potential litigation if the “complementary” treatment proves useless.

But what does “works with your body’s natural ability to heal itself” mean? Every medicine works, in some way, with the body. If you put aspirin in a bottle, nothing happens. But put aspirin in the human body, and it works with the central nervous system to relieve pain. Any medicine, then, “works with the body’s natural ability” to heal or treat itself. The real question is how well that medicine works.

Essential oils marketers, like doTERRA and Young Living Essential Oils, claim that their products help with thyroid function, eliminating toxins, balancing hormones, promoting respiratory health, and improving immunity. Young Living even offers a product meant to be applied “topically over the liver,” which costs $172 for about one tablespoon.

I asked Alice what would be best for my chronic stress headaches and migraines. She immediately launched into a list of proprietary blends, as well as individual oils.

“Peppermint, eucalyptus, Past Tense, Deep Blue… Oh, there are lots,” she said.

“Deep Blue is amazing,” the woman next to me said, leaning in and nodding her head adamantly. “You want Deep Blue.”

I took a note of the name of the proprietary mixture. Deep Blue comes in a roll-on oil blend as well as a lotion and contains wintergreen, camphor, peppermint, blue tansy, German chamomile, helichrysum (a sunflower-like bud), and osmanthus (an Asian evergreen). It should not be confused with the computer that plays chess.

Alice and Marie passed around samples of the oils, which everyone smelled and cooed over.

“Ooo, that’s nice!” we would say when something was pleasing.

“Hmm, interesting,” we would say when it was awful.

Alice continued her pitch as grapefruit oil went around the circle.

“Oils are so amazing because they work on so many different things. The same oil might help with a bunch of different things. And you can put it right on the thing that you’re treating, or you can put it on your feet.”

“On your feet?” I repeated.

“Yeah, on the acupressure point that corresponds to the body part you want to help,” Alice explained. “Or just put it all over your foot. That’s what you can do with a child, if you don’t want them to lick it off.”

I pictured Marie’s daughter licking sandalwood oil off her arm.

After discussing the various oils for sale that night, the women passed around a book called Modern Essentials that, they said, was like the Bible of essential oils. For nearly every problem, there was an oil to help solve it. I flipped through the book and found alleged oil solutions for countless serious conditions: diabetes, cancer, even clubfoot. Even the woman next to us, a true believer, had to laugh at the thought of oils forcing a crooked foot straight.

As we left, the teachers handed us samples of Deep Blue and lemongrass oil. Coincidentally, these samples were perfect for two of my issues: Deep Blue treats headaches, and lemongrass oil treats broken bones; perfect for my right arm, which never fully healed after I shattered my elbow at age nine.

We decided to do a full experiment: Ross would try to treat his acne and sore shoulder (from a sports injury he incurred a year ago), and I would try to treat my broken arm and headaches. Plus, we would loop in someone who could really step up our game: comedian Drew Spears would attempt to cure his cerebral palsy. According to one blogger, the cofounder of doTERRA encouraged her to use cedarwood oil to treat her son’s cerebral palsy. (It should be noted that the blogger is also a doTERRA seller.)

I stopped at Lassen’s Natural Foods, a store near my home that was sure to sell essential oils. The cost was certainly not prohibitive: It cost about $30 total to buy two bottles of cedarwood oil (coincidentally, cedarwood is the preferred treatment for both Ross’s acne and Drew’s cerebral palsy) and some eucalyptus and rosemary oil for my headaches. I combined my headache-fighting ingredients (including peppermint oil, which I already had on hand) into a spray to use on my face when a headache hit. I would also apply lemongrass oil topically to my broken elbow twice a day. Ross would be treating his acne once per day, while Drew would treat his cerebral palsy twice a day.

Drew tries putting oil on his feet so that it can seep into all of his pressure points.

The first time I applied my lemongrass oil, the smell filled my apartment immediately. Lemongrass is a pleasant odor, though it reminds one a bit of cleaning products. I took a photo of my before arm bent sharply downward against nature. I would chronicle my surely miraculous recovery as I applied the oil.

Meanwhile, Ross would use the cedarwood oil and compare his results with his typical acne breakouts. Likewise, Drew would apply his cedarwood oil twice daily to see if he would gain improved mobility and flexibility in his right arm and right leg, which are both affected by his condition.

It didn’t take long for a headache to hit, and when it did, I tried the Deep Blue first and the oil spray every subsequent time. At first, there was a marked difference. The overwhelming smell of peppermint, eucalyptus, and rosemary would fill my nostrils and the pain would go away. But it would return within seconds, requiring more application of Deep Blue or oil. Sometimes the peppermint would be so strong it would burn my eyes. It seemed I had to trade head pain for potential blindness. Perhaps the oils worked similarly to capsaicin to suppress headache pain through the nasal receptors, though its affects were clearly short-lived.

After two weeks of applications, we tallied our results:

Ross’ acne: Improved! Like tea tree oil, cedarwood oil appears to reduce acne outbreaks for some people. Ross was delighted to find that his acne had decreased after he started using the topical treatment. Unfortunately, his wife found the smell so intolerable that once the experiment was over, the oil became junk in the bottom of the bathroom drawer.

Ross’ shoulder pain: Only temporary relief during Deep Blue application. Like Icy-Hot, it provided a topical analgesic effect that quickly wore off, leaving him where he started.

My headaches: No sustained improvement. While the spray provided immediate relief, the effect quickly evaporated, and I was stuck with the usual treatments of aspirin, caffeine, and acetaminophen.

My broken arm: No improvement. My arm bends “the wrong way” to the exact same degree that it did before the experiment began.

Drew’s cerebral palsy: No improvement. While Drew thought the experiment was mostly funny, he pointed out that using it on a child, or giving it to someone who might really hope for a cure, is unconscionable. In short, he summed, “Fuck these people.”

When the experiment was complete, I contacted doTERRA for their side of the story. I asked them whether they encourage people to use essential oils for serious illnesses, whether their cofounder really told a woman to treat her son’s cerebral palsy with cedarwood oil, where they provide documentation of the science behind their claims, whether they consider their operation a multi-level marketing model, and why Drew saw no reversal of his cerebral palsy.

As of this writing, doTERRA has not responded.

* Names with an asterisk are pseudonyms.

Update: Since the publication of this article, we have received a reply from doTERRA. It is presented here without comment:

“Thank you for your interest in dōTERRA. dōTERRA products are not intended to diagnose, treat, cure or prevent disease. There are many studies about essential oils found on a variety of resources. One good source for somebody beginning to learn about essential oils is www.doterrauniversity.com. We do not comment on people’s individual experiences. Everybody is different and may react differently to essential oils. dōTERRA is a direct selling company where those individuals choosing to build a business have may multiple levels of distributors they mentor, nurture, and support in their individual business building efforts.”

As a PhD student in medical sciences, people often ask me questions about diet and nutrition. The problem is that several bogus claims have spread and are widely believed. Sometimes it only takes a website posting a diet claim for people to start propagating it without any critical analysis. For example, very recently a meme claiming diet sodas harm kidney function achieved more than 150,000 shares on Facebook, even though the image didn’t offer any explanation for its claim. As historians of science Naomi Oreskes and Erik Conway put it in their book Merchants of Doubt, “the Internet has created an information hall of mirrors, where any claim, no matter how preposterous, can be multiplied indefinitely.” Here I discuss some myths about nutrition circulating in Brazil.

Coke Zero Is High in Sodium

The myth about Coke Zero is very common in Brazil. Some time ago I heard this claim being repeated on a local radio program. Questioning this claim doesn’t require any medical knowledge; you just need to compare nutrition information of different beverages or foods. In Brazil, a 350 mL can of Coke Zero has 49 mg of sodium. So, if Coke Zero really has a lot of sodium, every drink with more than 14 mg of sodium per 100 mL also has a lot of sodium. This myth probably started because Coke Zero has more sodium than Coke and Light Coke (the Brazilian version of Diet Coke). But people stop the comparison there because other diet sodas sold in Brazil, in fact, have more sodium. What about other common beverages? For example, in 200 mL of a Brazilian milk brand, there are 130 mg of sodium. I think that’s enough to raise suspicion: the milk has never been accused of having a high sodium amount and Brazilians drank milk long before Coke Zero came along. To debunk the myth completely, just search for “sodium” on the website of the Food and Drug Administration (FDA). According to the FDA,¹ 480 mg or more of sodium per serving (it’s usually 240 mL for drinks) is considered “high” in sodium. Also, 120 mg or less of sodium per serving is considered “low” in sodium. Thus, Coke Zero does not have a high amount of sodium; it has a low amount of sodium.

You Need to Detox Your Body

Figure 1. The “Detox Monstro” (“Detox Monster”) drink sold in Brazil.

In conventional medicine, detox is a treatment for drug-dependent patients, during which their drug is removed from their bodies. In this case, detox is a valid medical treatment; it’s not a myth. But it has another meaning: for alternative therapists, “detox” is the use of therapies to eliminate toxins from the body. The latter is much better known to laypeople—and it’s bogus. The idea of removing toxins from the body looks so appealing that, in Brazil, the name of a green juice made of apple, cucumber, cabbage, ginger, and mint is “Monster Detox” (Figure 1). But scientifically it doesn’t make any sense. Notice that most detox claims don’t identify which toxins they’re talking about. Second, as Edzard Ernst, emeritus professor of alternative medicine at Exter University, explained in an article in The Guardian,² if toxins did accumulate in the body, we would be dead or in need of medical intervention. In healthy persons, kidneys, liver, skin, and lungs eliminate toxins from our body. In 2012, Ernst published a paper about “alternative” detox.³ It’s astonishing that he wasn’t able to do a systematic review because, when looking for the literature in electronic databases, he only found articles about the conventional detox. As he explained in the article, alternative detox includes several different therapies ranging from different types of diets to skin bruising to colonic irrigation. However, published studies are of such poor quality that no conclusions can be drawn from them. The problem is not only the lack of evidence for benefit but the fact that it can also be dangerous, including malnutrition caused by diets, hepatotoxicity due to supplements, and perforation of the colon caused by colonic irrigation.

You Need a Gluten-Free Diet

Gluten-free diets can help people diagnosed with gluten sensitivity. For example, celiac disease is a serious autoimmune condition that causes intestinal inflammation triggered by a reaction to gliadin, a gluten component. Celiac disease is present in about 1 percent of Americans. There are reports of non-celiac gluten sensitivity (NCGS), but the evidence of its existence is still debatable. In her Skeptic article,⁴ Harriet Hall commented that one trial⁵ showed evidence for NCGS but other trials⁶ showed that, in fact, it is not gluten people are sensitive to; it’s Fermentable Oligo-, Di-, Mono-saccharides and Polyols (FODMAPs, certain types of carbohydrates). The problem is that people with no gluten sensitivity, in order to lose weight, have cut gluten out of their diets. It’s interesting to point out the lack of critical thinking: if someone actually loses weight on a gluten-free diet, it doesn’t mean it’s because of the absence of gluten. Gluten is a protein found in many grains, breads, cereals, and pastas. When a person adopts a gluten-free diet, it’s possible that he or she eats less of those things and ends up reducing calories. Besides, gluten-free diets can lack nutrients because whole grains, which contain gluten, are a good source of vitamins, fiber, and minerals. As written in a paper published in the Journal of the Academy of Nutrition and Dietetics,⁷ “despite the healthy claims for gluten-free eating, there is no published experimental evidence to support such claims for the general population. In fact, there are data to suggest that gluten itself may provide some health benefits.” The authors of this paper also noted, “There are no published reports showing that a gluten-free diet produces weight loss in persons without celiac disease or gluten sensitivity.” Remarkably, the paper’s authors also commented on the possibility of weight gain with a gluten-free diet.

Eating on Multiple Occasions During the Day Helps Weight Loss

A lot of people think increasing the number of times they eat each day helps them achieve weight loss. In fact, some earlier studies had showed inverse association between the number of eating occasions during the day and excess adiposity. However, researchers recognized underreporting of eating frequency and energy intake are strong confounding factors in epidemiological studies. Snacking is more likely to be underreported in obese or overweight people.⁸ Also, studies have found that participants reported implausible energy intake. When that was removed from the analysis, the association between eating frequency and body mass index became positive.⁹ Moreover, interventional studies measured daily energy expenditure and concluded that eating frequency has no discernible effect on it.^8,9 It’s important to note that there is a possibility that fewer than three daily meals impair appetite control. However, it is premature to make any recommendations on eating frequency for weight control for different factors, such as the short-term duration of studies.⁹ In conclusion, whenever you hear about the relationship between high eating frequency, obesity, and metabolism, you have enough reasons to be skeptical.

You Need Vitamin Supplements

This myth probably started because earlier studies had suggested a correlation between low vitamin levels and risk for diseases; this is the case of vitamin E and heart disease. Also, people believe that it’s better to be on the safe side and take vitamin pills in case they aren’t getting enough of it from their diet. But several randomized controlled trials have been done on this topic, and vitamins do not prevent chronic disease or death in people with no evidence of micronutrient deficiencies. Moreover, some studies showed that beta-carotene, vitamin E, and possibly high doses of vitamin A increase mortality. It’s exactly what the title of the paper says: “Enough Is Enough. Stop Wasting Money on Vitamin and Mineral Supplements.”¹⁰

Notes

1. FDA. “Sodium in Your Diet: Using the Nutri­tion Facts Label to Reduce Your Intake,” Available at http://www.fda.gov/food/ingredientspackaginglabeling/labelingnutrition/ucm315393.htm.

2. Mohammadi, Dara. 2014. “You Can’t Detox Your Body. It’s a Myth. So How Do You Get Healthy?” The Guardian. Available at http://www.theguardian.com/lifeandstyle/2014/dec/05/detox-myth-health-diet-science-ignorance.

3. Ernst, E. 2012. “Alternative Detox.” British Medical Bulletin. Available at http://bmb.oxfordjournals.org/content/101/1/33.long.

4. Hall, H. 2014. “Diet Myths. What Science Knows (and Doesn’t Know) about Food and Nutri­tion.” Skeptic. Vol. 19, No. 4.

5. Carrocio et al. 2012. “Non-Celiac Wheat Sensitivity Diagnosed by Double-Blind Placebo-Controlled Challenge: Exploring a New Clinical Entity. American Journal of Gastroenterology. Available at http://www.ncbi.nlm.nih.gov/pubmed/22825366.

6. Biesiekierski et al. 2013. “No Effects of Gluten in Patients with Self-Reported Non-Celiac Gluten Sensitivity after Dietary Reduction of Fermentable, Poorly Absorbed, Short-Chain Carbohydrates.” Gastroenterology. Available at http://www.ncbi.nlm.nih.gov/pubmed/23648697.

7. Glasser, G., and S. Angadi. 2012. “Gluten-Free Diet: Imprudent Dietary Advice for the General Population?” Journal of the Academy of Nutrition and Dietetics (September). Available at http://www.andjrnl.org/article/S2212-2672(12)00743-5/abstract.

8. Bellisle, F. 2004. “Impact of the Daily Meal Pat­tern on Energy Balance.” Scandinavian Journal of Nutrition. Available at http://www.foodandnutritionresearch.net/index.php/fnr/article/viewFile/1637/1508.

9. McCrory, M., and W. Campbell. 2010. “Effects of Eating Frequency, Snacking, and Breakfast Skipping on Energy Regulation: Symposium Overview.” The Journal of Nutrition. Available at http://jn.nutrition.org/content/early/2010/12/01/jn.109.114918.full.pdf.

10. Guallar et al. 2013. “Enough Is Enough. Stop Wasting Money on Vitamin and Mineral Supplements.” Annals of Internal Medicine. Available at http://annals.org/article.aspx?articleid=1789253.

Changes to the media over the past few decades have brought many distressing trends. Social media tend to reward emotional manipulation over truth-telling. News outlets, even well respected ones, rush to publish rumors and poorly substantiated claims. The fragmentation of news into ideological islands and search engines’ tendency to cater to our preferences have helped to polarize viewpoints.

But while we’re arguably awash in more misinformation than ever before, online media have also enabled tools and sources that help us evaluate dubious claims. I recently spoke at the Skeptic’s Toolbox, the annual skeptical workshop in Eugene, OR, about the variety of fact-checking tools available. It was less a lecture than a conversation, as the participants provided many of their own suggestions. While we can’t pretend to be comprehensive, our combined lists should provide a good starting point for your fact-checking needs.

What is “Fact Checking”?

Photo by futureatlas.com on Flickr

There are a variety of ways to answer this question. One way to think of fact checking is in light of its role in forming and evaluating arguments. As skeptics, we spend a lot of time looking for logical fallacies. But it takes more than sound logic for a conclusion to be true: the premises of the argument must be true as well or the entire argument falls apart.

We can investigate the soundness of our premises by examining internal consistency, external plausibility, and source validity.

• Internal consistency: If you read a claim and there are points of disagreement within the claim, that’s a sign of something wrong.
• External plausibility: We should check the story against what we already know, and we may also do more research to check it out further.
• Source validity: We must identify the source of the claim, verify the source’s identity, and consider the source’s motives.

The Fact-Checking Toolbox

Another way to think about fact checking is in terms of the tools at our disposal (all of which will also fulfill one or more of the roles above). I tend to think of these as a rough continuum, starting with the easiest types of checks, moving to the more involved. These categories are:

• Internal validity checks
• Looking up “facts”: fake news sites, fact-checking sites, reference sites
• Media-based investigations: photos, videos, originality checks, social media users

Internal Validity Checks

This basically boils down to being a critical reader. As you read a claim or article, look for features that can give you clues as to its reliability, such as:

• Does it make sense? Is there internal disagreement?
• Date of publication: It’s very common for an article to make the rounds, and people to get riled up about something they think is happening now—and then it turns out that it happened years ago.
• Does the text justify the headline? You’d be surprised how often it doesn’t! In the report Lies, Damn Lies and Viral Content, Craig Silverman of Columbia’s Tow Center for Digital Journalism found large numbers of articles where a headline would treat a rumor as if it were true, but the article body would say the claim was unverified or even false. And as we know, many people don’t read beyond the headline.
• What’s the source? This can help us judge what’s in front of us, and can alert us if we need to dig deeper, for example if the claim originated from an earlier source.

This leads us to the easiest kind of source to evaluate: the fake news or satire sites.

Fake News and Satire Sites

Fake news sites have many aims. Some are cynical ploys to make as much money as possible off of “clickbait” headlines. Some purveyors of fake news seem to actually see themselves as doing a public service by exposing how gullible people can be. Some of the sites I list in this section are genuinely funny or satirical sites, like The Onion, that people have mistaken for real news; some claim the mantle of “satire” even though there’s really nothing humorous about them. (I’m looking at you, National Report, with your hilariously po-faced report that an entire Texas town had been quarantined due to Ebola.)

So Step 2 in your debunking process should always be to make sure the story you’re looking at isn’t simply fake. To help, here’s a list of fake and satirical news
sites:^{[1],[2],[3],[4]}

• The Onion
• The Daily Currant
• The Daily Mash
• The Borowitz Report (The New Yorker)
• News Examiner (they run some true stuff, to fool you)
• National Report
• World News Daily Report
• Daily Buzz Live
• Huzlers
• Empire News, Empire Sports News
• Stuppid
• The News Nerd
• Newswatch28
• Newswatch33
• Naha Daily
• The Stately Harold
• NewsBuzzDaily
• Free Wood Post
• Betoota Advocate
• MediaMass
• United Media Publishing
• Super Official News
• The Beaverton
• The Landover Baptist Church

But remember that new fake sites pop up all the time. Don’t see the site you’re evaluating on this list? Here are some things to try:

• Look at the website’s “About” page. Sometimes these sites do disclose if they’re meant as satire.
• Google “fake news” and the publication name.

Finally, if a story mentions “Paul Horner,” run like the hills—he’s a fake news maven (founder of News Examiner, contributor to National Report) who likes to insert himself in stories.

Fact-Checking Sites

The next stage is to see if someone has already debunked the story or claim. If the debunking site you use is reliable, I see no shame in this—there’s plenty of bullshit out there for us all to investigate, without repeating someone’s else’s work.

Of course, that “if” is important. Even serious news sites that we generally trust can get a story dead wrong. I therefore limit my definition of “fact-checking sites” only to dedicated organizations whose raison d’etre is to thoroughly investigate claims, and who have a track record of doing so well.

Fact checking has really picked up steam as a movement within political reporting: There are now sixety-four sites around the world active in political fact checking, compared to forty-four a year ago.^[5] Today in the United States, there are over two dozen fact checking organizations, though fact checking of national politics is dominated by the big three organizations: FactCheck.org, the Washington Post Fact Checker, and PolitiFact, which has affiliates in several states. These are great places to check on claims made by politicians.

But fact checking occurs in other realms too. Here are a few of my favorite fact-checking websites:

SciCheck

This site was launched about six months ago by FactCheck.org, which is based at the University of Pennsylvania. SciCheck focuses on addressing scientific claims that are made within the political arena. They can’t get to every such claim, of course, but if the claim you’re checking falls in this arena, SciCheck is certainly worth a look.

@FakeAstropix

Fake photos are a big problem online. People will post a picture of one thing claiming that it depicts something else; or Photoshop a photo to depict something that never was; or circulate a picture without proper attribution. There are Twitter accounts devoted to sharing pictures without any regard for whether the images are actually real. Fake astronomy pictures (such as those ever-present giant moons) seem to be a popular category, and to counteract that we have the fine folks at @FakeAstropix, a Twitter account. Another good Twitter account, focusing on fake pictures of all sorts, is Pic Pedant.

Health News Review

I really like this site, run out the University of Minnesota, which tries to address the very real and pressing problem of terrible health reporting. Health News Review has a team of over forty reviewers, mostly medical professionals, who grade mainstream health news articles against ten criteria—things like: Does the article engage in disease-mongering? Does the article discuss the costs of the proposed intervention? Was the study in question done on mice rather than humans? They spell all this out for the reader and they give the article a rating.

Other fact-checking sites:

Snopes
Hoax Slayer
Antiviral (Gawker) - note that Antiviral posts from April 2014 and before are available here.
What Was Fake on the Internet This Week (Washington Post)
Sense About Science: For the Record
HoaxBusters
PicPedant
Emergent: Sadly, this site is no longer active, but since hoaxes tend to crop up again and again, there’s a good chance what you’re trying to debunk may be listed here.

The following sites do excellent fact checks, though it’s not all that they do; use their menus or search functions to see if they’ve fact checked the claim you’re interested in.^[6]

Science-Based Medicine
Bad Astronomy
Bad Science

Reference Sites

Photo source

What if no one has debunked the claim already? There’s lots of reference sites that can help you check out the claim against an existing body of knowledge. It’s good to have a list of them at your fingertips, which is why my fellow Skeptic’s Toolbox attendees and I brainstormed the items below.

But the scope of human knowledge is vast, and sometimes a reference that works great for one type of claim just doesn’t help on another. What are some good general principles for finding reference works?

My top tip is to be creative with your Googling. Rethink the aim of your search, and the various ways the desired information may be presented. For example:

• Look for the organizations that are connected with your topic. Let’s say I have a question within pediatrics. If I don’t know what organizations cover pediatrics, I can Google “pediatrics” or “pediatrics organization” to find that the American Academy of Pediatrics is a leading authority. If I want to Google search within their website, I append the search string “site:aap.org” to any search terms I want to use.
• Look for people. For example, you could combine the term or topic you’re interested in with “expert” or “professor” (always using critical reasoning to judge the qualifications of the people you find, of course!). If you’re trying to understand something complex, consider sending an expert a polite email to ask if you can talk by phone for a few minutes. Human conversation is invaluable because when you’re exploring a topic, it’s easy to form misconceptions—and not to know what it is that you don’t know. A real, live person can point out where you’ve gone astray. Lay out your preconceptions and let the expert correct you.
• Look for journals and journal articles, using Google Scholar. Even if you’re not prepared to dig deep into the journal articles themselves, oftentimes a scan of study titles can give you an idea of how a subject is addressed by experts, which can enable further searches. Also try searching for “review” or “meta-analysis” to find studies that synthesize large bodies of research.

One more note on finding good references: while Wikipedia should never be treated as a primary source, its footnotes are actually a great way to find works that you can rely upon.

Here are some reference sites to try, grouped loosely by category.^[7]

Medicine:

Quackwatch has a wealth of information—including lists of further great resources. Check out their lists of “Comprehensive Medical Sites,” “Specialized Information Indexes” (click and scroll down a bit), “Interesting Web Sites.”
Cochrane Library (database of systematic reviews)
Science-Based Medicine (overviews and resource links for acupuncture, vaccines/autism and more)
Mayo Clinic (personal health information)
PubMed (medical studies)
Dietary Supplement Label Database - National Institutes of Health
Physician’s Desk Reference (prescription drug information)

Other science and math:

Skeptical Science (all about climate change)
Science Reference Services - Library of Congress (a list of reference guides, by subject)
Institute of Physics (search across a suite of pre-reviewed sites)
PLOS ONE (open access journals)
Dino Directory (identifying dinosaurs!)^[8]

Other topics:

education.iseek.com (a knowledge-focused search engine that looks across thousands of pre-approved sources, including universities, governments, and non-profits, on any academic topic imaginable)
Journalist’s Resource (curated studies on a variety of topics)
Oxford English Dictionary (can be accessed from libraries)
OneLook (search across over 1,000 dictionaries)
Google Ngram (see how use of a phrase has changed over time)
CIA World Factbook (facts about countries)
Global Edge (statistical information about countries, and business stats by state, industry and more)^[9]
National Security Archive (declassified U.S. government documents, hosted by George Washington University)
Sourcebook of Criminal Justice Statistics^[10]
U.S. Census Bureau: Economic Indicators
Bureau of Labor Statistics: Labor Force Statistics
Give.org and Charity Navigator (info on charities)
Khan Academy (videos on math, science, art history, and more)
Internet Archive “Wayback Machine” (see caches of websites saved earlier)^[11]
AMBER Alert Program (list of active alerts, from the National Center for Missing & Exploited Children)^[12]

Photos

What happens when can’t check a claim against a database of facts, but have to compare the claim against reality yourself? This is often the case when it comes to photos, videos, and claims made on social media.

When you want to check out the veracity of a photo, there are a few key questions to ask:

• Does this image show what it purports to show? (One of the most common types of photo hoaxes is simple misattribution: a photo of Japanese tsunami victims, say, reused to supposedly show earthquake survivors in Nepal.)
• Has this photo appeared anywhere else online?

Further questions that might help to ask are:

• When was this photo taken?
• What type of camera was used?
• Was the photo altered?

As with text, you can save yourself grief by first going to fact-checking sites (see above) to see if someone has already debunked the photo.

After that, your next step should be a reverse image search to see where else the image has appeared. To use these sites, you can upload an image or enter its URL. (The URL should be for the image itself, not a website containing the image.)

Key tools for this are:

• Google Reverse Image Search (tutorial here)
• TinEye

Next, try one of several tools that will check the image’s EXIF data to tell you the date and time the photo was taken and modified. These tools can also tell you what kind of camera was used, camera settings employed, and sometimes GPS location. These tools can, however, have trouble with social media sites, which strip out a lot of metadata.

Key tools:

• Jeffrey’s Exif Viewer
• Findexif.com

Then you can do more detailed work using tools that examine the photo file itself, to determine when it was taken and look for alterations. Some of these tools have a bit of a learning curve.

The tools include:

• FotoForensics (tutorials here)
• JPEGSnoop
• Image Edited?
• Izitru

Videos

There are a few tools to help you with video. YouTube Data Viewer gives you the upload time of a video and can help find earlier versions of the same video, using a reverse image search. If you need to slow down or brighten a video to try and make out certain features within it, try Tracker and VLC Media Player.

Originality Checks

It’s often important to see if the text you’re looking at has been copied from another source. For example, Googling text from badly written science articles can often turn up the original press release. Anti-plagiarism tools like Turnitin are also useful for this purpose. (You might need to sweet-talk an academic friend in order to access this tool.)

Verifying People

The logo for Bot or Not

If you’re looking at a post on social media, you may need to ask about the poster:

• Are they who they say they are?
• Are they near the action they’re describing?
• Are they even human—maybe they’re a bot? According to one study, about 13 percent of Twitter users are bots.^[13]

Some of these checks don’t even require wheeling out special tools. For example, if you’re looking at a social media account of a supposed public figure, does the account have a blue “verified” tag? (If so, hover over the check mark with your mouse to see if the text “verified account” pops up.) When was it created? (Very recently created accounts are a good sign of a hoax.)

Some of the tools you can use are:

• LinkedIn Advanced Search
• Twitter Advanced Search
• Topsy - This is a good tool for seeking tweets from a specific time period.
• WebMii - This tool lets you search by name to find social media profiles, photos, video, and more. It has a “web visibility” score that can help identify fake profiles.
• Bot or Not? - This initiative of the Truthy Project at Indiana University evaluates the likelihood that a given Twitter user is actually just a bunch of code.
• Google Maps and Google Earth - These tools can help you figure out if a photo or video was shot where its promoters claim.
• Wolfram Alpha - This knowledge engine has lots of uses. Among them, it can tell you what the weather was like in a certain location on a certain day—again, useful for debunking photos and video.
• WhoIs - Lets you look up who owns a website, and when it was last registered. Note that you want https://who.is, not the similarly named whois.com or whois.net.

Finally, sometimes you may even want to reach out to someone in real life, but can’t find contact details. Or you have a number, but need their name.

These services will help you do that:

• Pipl.com
• Spokeo.com
• SearchSystems.net
• Rapportive
• AnyWho
• AllAreaCodes
• Numberway

Further Resources

If you’re hungry for more fact-checking help, here are some resources you might find useful:

The Verification Handbook - This resource, edited by Craig Silverman, is designed for journalists. But don’t let that stop you; it’s got loads of handy tips, case studies of fact-checking tools at work, and deeper explanations of some of the tools described above.
Skeptools - A blog by Tim Farley, with excellent examples of how to use fact-checking tools.
Verification Junkie - A listing of verification tools, maintained by journalism foundation executive Josh Stearns.
Fact-checking resources - A guide I wrote for the Fact-Checking Project of the American Press Institute. It goes into more detail on some of the social media tools above, and also gives resources for several hot-button political issues.

I hope you’ve found this overview helpful. To my mind, the project of cataloguing reliable online sources is an important one—but one that is just beginning. What are your favorite fact-checking tools and resources?

^[1] http://factually.gizmodo.com/the-9-worst-fake-news-sites-1681729157

^[2] http://antiviral.gawker.com/the-antiviral-guide-to-the-worst-hoaxers-and-liars-on-f-1676552746

^[3] http://www.washingtonpost.com/news/the-intersect/wp/2015/07/10/what-was-fake-on-the-internet-this-week-beyonce-and-jay-zs-quest-to-buy-the-confederate-flag-and-pea-guacamole/

^[4] Skeptics’ Toolbox participant suggestions

^[5] http://reporterslab.org/snapshot-of-fact-checking-around-the-world-july-2015

^[6] Skeptics’ Toolbox participant suggestions

^[7] Thanks again to Skeptics’ Toolbox participants for their suggestions, incorporated here.

^[8] http://www.ala.org/rusa/sections/mars/marspubs/marsbestfreewebsites/marsbestref2014

^[9] http://www.ala.org/rusa/sections/mars/marspubs/marsbestfreewebsites/marsbestref2014

^[10] http://www.ala.org/rusa/sections/mars/marspubs/marsbestfreewebsites/marsbestref2014

^[11] Tim Farley has a nice overview of how this and similar tools can be used: https://skeptools.wordpress.com/2009/06/10/web-archive-skeptic-tool/

^[12] https://sweetyetunrefined.wordpress.com/2015/07/09/science-thursday-fact-checking-and-sharing-on-social-media/

^[13] Chu, Z., Gianvecchio, S., Wang, H., and Jajodia, S. (2010). Who is tweeting on Twitter: Human, bot or cyborg? Proceedings of the 26th Annual Computer Security Applications Conference (pp. 21-30). Austin, Texas.

As early as 1711, the old English word bitter (from biting) was extended to mean a “bitter medicinal substance” (according to the Oxford English Dictionary, 1971). In his “first” dictionary, A Dictionary of the English Language (1755), Dr. Samuel Johnson records this extended meaning (citing Locke), “In medicine, a bitter plant, bark or root.” In time the word for this meaning was given as bitters, as in Noah Webster (1849, 125), “A liquor in which bitter herbs or roots are steeped; generally a spirituous liquor. . . . In the materia medica, the term bitters is applied to such medicinal substances as are characterized by their bitterness”—especially as are thought to exert a “tonic power on the digestive organs.”

According to one authority, bitters appears to have originated in Germany in the seventeenth century, and then spread to Italy and England. In the latter country during George II’s reign (1727–1760), gin began to be regulated. It was taxed and the number of taverns was limited. As a consequence, “the gin sellers added various herbs to their product and sold it as a medicinal liquor (a ploy that has been used ever since in many countries whenever there have been attempts to control the distribution of spirits)” (Munsey 1970, 111).

Bitters Cocktail?

One such bitters has an interesting story. According to several popular sources, the cocktail was invented in the early nineteenth century in New Orleans by a Creole apothecary using bitters as an ingredient.

The pharmacist was Antoine Amédéé Peychaud, whose history is murky—various sources say he arrived in New Orleans as early as 1795 or as late as 1824. However, he was apparently married there in 1811. He eventually opened his own “Pharmacie Peychaud” on Royal Street in what is today called the French Quarter.

Figure 1. Peychaud’s “first” cocktail can still be made with these available ingredients (described in the text).

It is said that Peychaud liked to drink his cognac brandy from an egg cup, and in this fashion he served drinks at his shop, beginning with his fellow Freemasons after their meetings. Supposedly he added bitters, along with sugar and water, thereby—according to dubious legend—creating the first cocktail. In any event, the French egg cup was called a “coquetier” and this may indeed have evolved in pronunciation (through cock-tay) to cocktail ¹ (Peychaud’s Bitters 2014; Downs and Edge 2000, 196). (See Figure 1.)

Peychaud reportedly began to market his bitters in 1830. The rights to the product were purchased by Thomas H. Handy in the 1870s. Today Peychaud’s is used more or less exclusively as a flavoring in cocktails. Sweeter than another popular brand, Angostura Bitters, Peychaud’s is still made in Louisiana, a bright-red liquid sold in five-ounce bottles, its ingredients including gentian root (Peychaud’s Bitters 2014).

Hostetter’s Bitters

Figure 2. Almanac advertising booklet for Hostetter’s Stomach Bitters.

A much more widely known bitters in its time, an alleged “vegetable tonic” (restorer of normal tone), “alterative” (health reestablisher), and “stomachic” (stomach medicine), as well as a “gentle laxative” and “anti-bilious agent” (a liver treatment), was Hostetter’s Stomach Bitters, as described in one of its almanacs (an advertising giveaway) of 1866. (See Figure 2.) Deriding “homeopathists” and “skeptics,” the booklet claims, “. . . it is endorsed by practical chemists as the safest, and by unprejudiced physicians as the SUREST PREVENTATIVE, REGULATING, and RESTORATIVE PREPARATION OF THE AGE.”

The product originated about 1852–1853 (the almanac says it has “been about fourteen years before the public” [p. 15]). In partnership with George W. Smith, David Hostetter of Pittsburgh began to manufacture a formula developed by his father, Dr. J. Hostetter. In its early form, Hostetter’s contained various amounts of alcohol—up to 47 percent (Fike 2006, 36). This consisted of “good Monongahela spirit,” i.e., “essence of rye,” indeed “Sound Rye,” which was “mixed with the juices of tonic and alterative roots, barks, and herbs” (p. 3).

Hostetter and Smith claimed to have received “voluminous correspondence” from throughout the United States and South America, without a single expression of dissatisfaction. A few testimonials are included in the almanac. Generally, the users have endorsed the wide range of afflictions for which the bitters were said to be effective (pp. 3–21). In addition to those already mentioned, they included indigestion, flatulence, nausea, nighttime restlessness, palpitation of the heart, memory loss, depression, sour stomach, dimness of the eye, chills and fever, diaphragm pains, feebleness, nervousness, unsteady appetite, sudden spasms, nervous headaches, hysterics, bowel complaints, unease of pregnancy, and more—even hypochondria!

So much was Hostetter’s a cure-all that it could replace “a whole medicine-chest full of tinctures, essences, powders and pills” (p. 10). And not only did it claim to cure but also to prevent the effects of poisoned air and water as an “unequaled tonic and disinfectant” and to provide “an absolute protection against intermittent and remittent fevers” and, indeed, “all epidemics” including malaria. It was also claimed to be an antidote to mercury poisoning, and (perhaps not surprisingly) “in cases where a morbid craving for alcohol has been generated,” the bitters “will be found an efficient means of allaying it”!

Hostetter’s was always sold in bottles (these were embossed beginning in 1858); the proprietors decried “unscrupulous impostors” who “pretend to sell the article by the gallon or barrel” (p. 23). After Smith’s death in 1884, the enterprise became Hostetter & Co., still operated by the family. After passage of the 1906 Food and Drug Act, the alcohol content was lowered to 25 percent. During prohibition, the herbal content was increased to compensate for the loss of alcohol, but this produced an almost unbearable taste and consequently poor sales. The formula was restored after the repeal of prohibition, and it survived until 1958 (for its last four years known as Hostetter Tonic) (Fike 2006, 36).

As shown by an advertisement on the back of the almanac (Clark & Barker, dealers in drugs, medicines, chemicals, etc., in Fredonia, New York), local drug or general stores were thereby identified as “agents for the sale of Hostetter’s Celebrated Stomach Bitters.” The almanacs may have been provided without cost to the agents in return for their ordering a certain amount of the product.

Atwoods et al.

Numerous other bitters were sold—from A (African Stomach Bitters) to Z (Zingari Bitters). Among them was Moses Atwood’s Jaundice Bitters, sold originally as “Genuine Vegetable Physical Jaundice Bitters,” beginning in 1840 at Georgetown, Massachusetts. (It is often confused with Charles Atwood’s Quinine Bitters, the pair evidently being competitors.) Slightly more than a quarter of its volume was alcohol. It was claimed to be “an effective cure for jaundice, headache, dyspepsia, worms, dizziness, loss of appetite, darting pains, colds and fevers.” Also, it “cleanses the blood from humors and moistens the skin. It is also good for liver complaints [hence its name], strangury [slow, painful urination], dropsy, croup, and phthisic [i.e., phthisis, a consumptive condition].” (Fike 2006, 30.)

Figure 3. Bottle and advertisement for Baxter’s Mandrake Bitters. (All items from author’s collection.)

Advertised as early as 1881 was Dr. Henry Baxter’s Anti-Bilious and Jaundice Mandrake Bitters. An advertisement (Figure 3) promised to “expel all morbid secretions and obstructions from the system, stimulate the internal organs into healthy action, and purify the blood.” It asked, “Are you suffering with any of the diseases that follow a torpid or diseased Liver—such as Jaundice, Dyspepsia, Bilious diseases, Foul Stomach, Costiveness [constipation], or Weakness? Then these Bitters will do you good.” They sold for twenty-five cents per bottle. Also shown in Figure 2 is a twelve-paneled, aqua, embossed bottle with paper label dating from the later nineteenth century. It was manufactured by Henry, Johnson & Lord, Proprietors, Burlington, Vermont. Much later the product was sold by the Burlington Drug Co. (Fike 2006, 31).

The name “Dr. Baxter’s Mandrake Bitters” suggests a possible ingredient. It was unlikely to contain the European Mandrake, but it could have included the so-called American Mandrake or Mayapple—once thought safe to use as a purgative but now known to be dangerous if taken internally (due to its cytoxic, or cell-killing, action) (Chevallier 1996, 250). Other bitters whose names suggested a main ingredient included California Fig & Herb, Curtis & Perkins Wild Cherry, Gilbert’s Sarsaparilla, Oregon Grape Root, Prickly Ash, Angostura Bark, Buhrer’s Gentian, Dr. Chandler’s Ginger Root, Dr. C.D. Warner’s German Hop, and Begg’s Dandelion Bitters (Fike 2006, 29–44; Kovel and Kovel 1979, 30–42).

Analysis by government chemists acting under the 1906 Food and Drug Act (effective from the beginning of 1907) revealed the medically doubtful contents of many bitters concoctions. For instance, Hamburg Stomach Bitters was revealed to contain only “a sweetened water and alcoholic liquor flavored with a small amount of flavoring material and colored with caramel.” Kaufmann’s Sulfur Bitters did not contain an appreciable amount of sulfur as alleged, and its claims of treating diabetes and curing syphilis and leprosy were declared false and fraudulent. Proprietor Aaron P. Ordway was convicted and fined. Again, a Pale Orange Bitters of Cincinnati was found to be 32 percent alcohol colored with caramel; the defendant was fined. Yet again, a Pepsin Magen Bitters was revealed to contain only “an infinitesimal quantity of pepsin,” some sugar, and 28.44 percent alcohol. The Bettman–Johnson Company was fined accordingly. The list goes on (Nostrums and Quackery 1921, II: 748–754).

Harmful Ingredients

Not only were the ingredients of most bitters unspecified (until the 1906 Food and Drug Act), but even popular herbal remedies could be harmful in certain cases. We have already looked at American Mandrake. For another example, wild black cherry bark—touted to relieve coughs, diarrhea, indigestion, and irritable bowel syndrome—is “highly toxic” if taken in excessive doses (Chevallier 1996, 255).

Then there was alcohol, a common ingredient. Specified so were Clarke’s Sherry Wine Bitters, Greeley’s Bourbon Bitters, Doctor Gregory’s Scotch Bitters, and, among others, Tippecanoe, Chapin & Cone Sour Mash Bitters. Dr. Henley’s Wild Grape Root Bitters reportedly contained 52 percent alcohol in 1905. When the proprietor of Dr. Harter’s Wild Cherry Bitters died, his enterprising daughter married a whiskey manufacturer. Wholesale liquor dealers were themselves makers of some bitters, such as German Balsam Bitters of Oakland, California, and Hibernia Bitters of San Francisco.

Concludes one source (Kovel and Kovel 1979, 30), bitters “was often of such high alcohol content that the user felt healthier with each sip.” Still the proprietors of Brown’s Iron Bitters insisted theirs was “A Valuable Family Medicine. Not a substitute for whiskey. Not sold as a beverage. Not composed mostly of spirits. Not sold in bar-rooms.” Some bitters, like Dr. Webb’s, succumbed to prohibition (Fike 2006, 29–44).

The American Medical Association, in its Nostrums and Quackery (1921, 7–40), cited Hostetter’s Stomach Bitters (discussed earlier), noting that its contents were 25 percent alcohol or half the strength of straight whiskey. If one took the daily dose of six tablespoons of Hostetter’s, one would drink the equivalent of nearly two bottles of beer or one-and-a-half shots of whiskey.

Needless to say, alcohol could exacerbate some conditions. And who today would think it suitable for a pregnant woman to take—especially in unregulated amounts? Nor was alcohol the most outrageous ingredient of some bitters.

Patent medicines of the day sometimes contained cocaine, among them a product sold by J.F. Miller of Chicago (under the name R.W. Davis Drug Company). This was called Cocainized Pepsin Cinchona Bitters. Not only did it lack pepsin, but it contained cocaine and cocaine derivatives without mention of that fact on the label. The amount of alcohol contained was also incorrectly stated, and the company made “false and misleading” claims that it would purify the blood and act speedily as a remedy for a host of ailments. It was analyzed by government chemists, declared misbranded, and—following an entered plea of guilty—Miller was fined (Nostrums and Quackery 1912, I: 551).

Bitters Bottles

Most bitters bottles date from 1840 to 1900, and some were hand-blown. The earliest ones were free-blown (typically showing on the base a round scar where a pontil rod was temporarily attached by a blob of molten glass to hold the bottle for finishing); later ones were mold-blown (as evidenced by seams running from the bottom to somewhere along the neck). By 1903, bottles began to be made by the automatic bottle machine (and they exhibit seams that, as a rule, run the full length of the bottle, extending over the top). (For a fuller discussion, see Fike 2006, 11–12; Munsey 1970, 30–36, 47–50.)

Bitters bottles are highly collectible. They exist in a great variety of shapes—typically flat front and back (i.e., having a rectangular base), but also cylindrical, multi-paneled (e.g., twelve-sided for Atwood’s Jaundice Bitters), and artistic forms, including figures like barrels (especially for those containing bourbon whiskey), a lady’s leg, even (for example, for American Life Bitters of Omaha) a log-cabin shape. They are found as well in various colors of glass: clear, aqua, green, differing hues of amber, light blue, cobalt, amethyst, and (very rarely) red, among others. Due to such variety, experts caution, “The word bitters must be embossed on the glass or a paper label must be affixed for the collector to call the bottle a bitters bottle” (Kovel and Kovel 1979, 30–31).

Bitters bottles are a window into an earlier era of quackery (although sometimes perhaps well-intentioned), as well as into the related worlds of unbridled advertising, liquor sales and consumption, and, of course, the very human need for relief from myriad ailments. Bitters may sometimes have alleviated these, but more often only pretended to—no doubt sometimes causing actual harm, perhaps especially to the untold unborn.

Note

1. The Oxford English Dictionary (OED) (1971) says cocktail is a slang American term of lost origin, known from as early as 1809. At issue is the definition of the word, the OED describing it as “consisting of spirit mixed with a small quantity of bitters, some sugar, etc.” However, the word has come to mean any mixed drink of distilled spirits and would include juleps, which are centuries older than Peychaud’s cocktail (Nickell 2003, 4–6).

References

Chevallier, Andrew. 1996. The Encyclopedia of Medicinal Plants. New York: D.K. Publishing.

Downs, Tom, and John T. Edge. 2000. New Orleans. London: Lonely Planet Publications.

Fike, Richard E. 2006. The Bottle Book: A Comprehensive Guide to Historic, Embossed Medicine Bottles. Caldwell, NJ: The Blackburn Press.

Hostetter’s United States Almanac. . . . 1866. Pittsburgh, PA: Hostetter & Smith.

Johnson, Samuel. 1755. A Dictionary of The English Language. Abridged from an edition of 1756; reprinted New York: Barnes & Noble.

Kovel, Ralph, and Terry Kovel. 1979. The Kovels’ Complete Bottle Price List. New York: Crown Publishers.

Munsey, Cecil. 1970. The Illustrated Guide to Collecting Bottles. New York: W.W. Norton & Company.

Nickell, Joe. 2003. The Kentucky Mint Julep. Lexington: University Press of Kentucky.

Nostrums and Quackery. 1912, 1921. Second ed.; vols. I, II; Chicago: American Medical Association Press.

Oxford English Dictionary, The Compact Edition of. 1971. New York: Oxford University Press.

Peychaud’s Bitters. 2014. Online at www.cooksinfo.com/peychauds-bitters; accessed December 4, 2014.

Webster, Noah. 1849. An American Dictionary of the English Language. Revised and Enlarged by Chauncey A. Goodrich. Springfield, Mass: George and Charles Merriam.

A skeptic sees no light at the end of the tunnel when she falls into a six-week coma and nearly dies.

We often see and hear dramatic accounts of near-death experiences (NDEs) in books, in films, and on television. But where are the stories from skeptics who “returned” but not from The Other Side? After all, NDEs are generally accepted as a neurological phenomenon. Well, most people who have NDEs actually die. Among the survivors, many are severely brain-damaged. Of those who do recover, most are believers. As for the skeptical ones, how many of them are writers? Not many, probably, but I am one.

“It’s the profound brain damage again,” has become a running joke whenever I say something stupid, a fairly common occurrence long before the strokes that caused my coma. This wouldn’t be very funny if I weren’t fully conscious now—excluding mornings. I’m writing this article not long after the first anniversary of my awakening. My boyfriend calls it Coma Day, and he’s never forgotten the date. I’ve never forgotten that first conscious moment.

I thought I was suffering through a miserably sleepless night, a recurring theme in what I call my coma-dream. Every time I finally managed to drop off, something would wake me up again. Whenever doctors shined lights in my eyes looking for signs of consciousness, I would grumpily ask them to leave me alone so I could get back to sleep . . . in the coma-dream. My lack of response in the real world only added to their conviction that my brain was, as they said, profoundly damaged. My mother, boyfriend, and his mother, who had visited daily, noticed signs of my increasing awareness, but their observations were disregarded by the doctors.

When I finally awoke, I thought, “Goddammit, I just fell back asleep.” That’s when my mother told me I had actually been sleeping for six weeks, on the brink of death. I was shocked. “Seriously?” I mouthed. I had a tracheostomy, so I couldn’t speak—a fate worse than death for me.

However, the doctors’ conclusions weren’t groundless. My MRI showed that I had suffered a series of strokes on both sides of my brain when my blood pressure plummeted from septic shock. The sepsis was triggered by Legionnaires’ disease, a rare form of severe pneumonia discovered when it sickened attendees at a Legionnaires’ convention.

In the waning days of a vacation in Sicily with my boyfriend, Keith, I came down with what we thought was nothing more than a nasty chest cold. We joked about my case of “Mussolini’s Revenge,” but it was far more serious than that. A few days after we returned home, he rushed me to the emergency room. I was so delirious that when he asked why I hadn’t turned on the air conditioning, I said, “I like the heat.” It was 105° that day, and I hate the heat.

Most of the victims at the Legionnaires’ convention were elderly. I caught the disease because my immune system was weakened by prednisone, which I was taking for an obscure autoimmune disease called dermatomyositis. It’s uncommon enough that I’ve often seen the dermatomyositis Wikipedia page on the computer screen when seeing a new specialist. And, yes, it is disturbing that medical professionals are using a questionable information source popular with schoolchildren.

Though the doctors continued to dismiss suggestions of my improving wakefulness, much of what was going on around me was filtering into my coma-dream. I wasn’t aware that I was in a vegetative state, but I knew I had a “trach,” a term I had previously heard only in medical dramas. Encouraged by an imaginary doctor, I blew large bubbles out of my nose—as if I’d been snorting bubblegum—when I had a sinus infection from my feeding tube. The constant thrumming was the machinery keeping me alive.

Near death isn’t required for a near-death experience. They can be triggered by severe illness and even fainting (from lack of oxygen to the brain). Though my coma-dream shared many similarities with typical NDEs, my experience was different because I’m a skeptic. The reason I didn’t see dead relatives is I don’t believe in life after death. Likewise, I didn’t see Jesus’s rainbow-hued horse because I’m Jewish and not a four-year-old imagining Jesus with a gay Little Pony. I did, however, dream of ice cream. Indeed, while my life didn’t flash before my eyes, childhood elements figured prominently in the revolving segments of the coma-dream. On my Brain TV, some shows were repeats, while others had advancing plots like soap operas. I had a lot of time to kill.

One serial featured a low Big Wheel–like kid’s tricycle that churned ice cream in a cart attached to the back as it was peddled. Actually, burning the calories you’re about to consume isn’t such a bad idea. Sometimes when I peddled this ice cream–making Big Wheel, I was an anthropomorphic polar bear cub. While I saw no religious figures, I imagined miniaturized zoo animals right out of a 1950s sci-fi film. They were having a tea party, like poker-playing dogs except with tiny china cups. You can see why I call this a coma-dream. These surreal images may be akin to the spirits believers see in their NDEs.

After the awakening, I felt like Dorothy waking up in bed after her journey down the Yellow Brick Road. So many of the things in the coma-dream suddenly made sense—except for the cub-powered ice cream Big Wheel and toy-sized elephant. The pachyderm held the teapot with its trunk.

Oh, that’s the reason snippets of The Hitchhiker’s Guide to the Galaxy, one of my favorite books, kept wafting into unrelated storylines. My boyfriend had read to me from the book, while my mother had played the original BBC radio series. I don’t believe the incursions always occurred when I heard them, though. My mother also used her e-reader to play some recent David Attenborough nature documentaries, including one on Charles Darwin. (As a former future-paleontologist, evolution has long been a special interest of mine.) Sometimes sections would repeat. I thought I was rewinding the program because my mind wandered (something I do frequently). My Brain TV had a DVR.

Author Stepahanie Savage while in her six-week coma.

Ah, so that’s why they kept asking me to stop biting the hose delivering Hi-C to my mouth as if from a beer hat. They weren’t risking cavities by giving me a sugary fruit-flavored drink; they were preventing them by cleaning my mouth with a citrus-flavored swab. If I had stopped biting the swab, I wouldn’t have had so much plaque on my teeth, the reason I was running my tongue over my teeth in both the coma-dream and in reality. I couldn’t understand how my teeth could’ve gotten that coated overnight. But then, the tooth-licking was one of the signs of recovering awareness that gave my loved ones hope, even if the doctors wouldn’t acknowledge it as such.

And my new boyfriend in the dream, the one who looked and sounded exactly like Keith in every way except his beard, actually was Keith, who had grown a full beard while I was in the coma. I wondered why his glasses had been repaired with the same kludge Keith devised in Sicily—with the sticky part of a clear Band-Aid. What a weird coincidence. Since this was a form of dream, that wasn’t a tipoff, even when I slipped and called him Keith.

But for most people in a vegetative state, they’re more likely to hear prayers and the Bible than Hitchhiker’s Guide. That must affect what they visualize in their NDEs. Indeed, the content of NDEs varies among cultures. I was raised without religion, but the disembodied voices I heard were not unlike spirit voices. My brain didn’t supply images of the afterlife because I believe life after death is a fantasy. Resistance to being awakened is similar to reluctance to return from The Other Side. Using Occam’s razor, which is more likely to be true?

If I had been a New Ager, seeing myself being turned over to prevent bedsores would’ve seemed like an out-of-body experience (OBE). But how many times have I watched myself from outside my body in an ordinary dream? Oh, wait—some people believe those are OBEs too. I once dreamed that a lion put its paw on my hand, only to wake up with my cat’s paw on my hand. It doesn’t take a genius to figure that one out. There’s nothing supernatural about that; it’s just sensory information mixed with imagination. Besides, my eyes were sometimes open, so my perceptions weren’t always imaginary. That’s how I knew Keith had grown a full beard.

According to the Merck Manual:

A vegetative state is absence of responsiveness and awareness due to overwhelming dysfunction of the cerebral hemispheres, with sufficient sparing of the diencephalon and brain stem to preserve autonomic and motor reflexes and sleep-wake cycles. Patients may have complex reflexes, including eye movements, yawning, and involuntary movements to noxious stimuli, but show no awareness of self or environment. (Maiese 2014)

Yet, there is growing empirical evidence of covert cognition in people who have been in a persistent vegetative state (PVS) for years. Using functional magnetic resonance imaging (fMRI), which determines brain activity by displaying blood-flow patterns, researchers from Cambridge University, including pioneering researcher Dr. Adrian Owen, were able to communicate with five patients with consciousness disorders by asking them to imagine one of two activities (Owen et al. 2006). In the motor task, they were instructed to imagine playing tennis. In the spatial task, they were asked to navigate familiar locations. The images lit up different brain regions. Four patients were able to answer yes or no questions with this technique (Monti et al. 2010). One answered five of six correctly. His “do not resuscitate” order was rescinded. The results were repeatable and corresponded closely to those of the healthy controls.

Kate Bainbridge, the first vegetative person Dr. Owen tested with positron emission tomography (PET), eventually recovered her mental faculties. “I was unresponsive and looked hopeless,” she later told him in a note, “but the scan showed people I was in there. It was like magic, it found me.” Today, she’s angry at the doctors who ignored her discomfort because they assumed she wasn’t feeling anything. The reason I was dreaming about ice cream—another serialized dream also involved ice cream—is probably because I was left uncovered in a frigid room.

Now at Canada’s Western University, Dr. Owen and his team recently conducted an fMRI study in which a man who had been vegetative for sixteen years responded with nearly identical brain patterns as the study’s healthy controls while watching “Bang! You’re Dead,” an episode of Alfred Hitchcock Presents (Naci et al. 2014). This indicated that he was following the suspenseful plot. Regarding the subject, Jeff Tremblay, Dr. Naci said, “For the first time, we show that a patient with unknown levels of consciousness can monitor and analyze information from their environment, in the same way as healthy individuals. We already know that up to one in five of these patients are misdiagnosed as being unconscious and this new technique may reveal that that number is even higher.” Since the Hitchcock experiment, they have tested patients using Charlie Chaplin’s Modern Times and The Lion’s Cage, which, according to Dr. Naci, have shown similar results.

If Mr. Tremblay is watching his own Brain TV, is he now seeing images of a little boy with a gun? Are the subjects of the Chaplin study imagining themselves caught in the cogs of a giant machine? Perhaps someday, through fMRI or emerging treatments, they will be able to tell us. When that day comes, what are the odds that they will report seeing the afterlife after all those years? You’d think their dead relatives would eventually return to the light so they can find something better to do.

Though many of these patients are misdiagnosed, without proper screening it’s impossible to know which ones. In my case, the minute the doctors saw the stroke damage they assumed I was beyond hope. The Glasgow Coma Scale wasn’t even performed, and it’s just a low-tech behavioral checklist. I was in a state-of-the-art hospital; imagine a patient in a less advanced facility.

My neurologist told me that the reasons I’ve recovered so well are that I was younger than the average stroke victim and most of my brain damage was in the watershed areas. Watershed areas lie between two major arteries. By the time blood reaches these sections, there’s less oxygen in it. It’s a bit like a wetland fed by two trickling tributaries. Together, they provide just enough water, but when the flow diminishes, the land between the tributaries dries up. As she explained, watershed areas don’t generally control vital functions. They die more quickly than more important regions, but they also spring back faster after damage has occurred. Ain’t evolution grand?

The “string of pearls” pattern of my watershed-area stroke damage should’ve been obvious to the neurologists examining my MRI. I can’t say why they didn’t add that evidence to my relative youth when predicting my chance of recovery. They did perform an electroencephalogram (EEG), which showed, not surprisingly, that I still had brain activity. Again, I don’t know why that didn’t figure into their evaluation. Perhaps they didn’t consider the mounting evidence that there is more awareness in the comatose and nearly—but not most sincerely—dead than previously realized.

Regarding the tennis study, “In the Blink of the Mind’s Eye” states, “This technology does more than open up the possibility of communicating with people thought to be unconscious and unreachable. It also suggests that neuroimaging must eventually be integrated into the clinical assessment of many patients who are vegetative or minimally conscious. This is a dramatic finding and a potential game-changer for clinical practice” (Finns and Schiff 2010). If that happens, there will be fewer seemingly miraculous recoveries because they won’t be such a surprise.

The perceptions of stricken brains are hardly inexplicable if awareness is more like a dimmer than an on/off switch. Moreover, NDEs can’t be proof of mind/brain separation if the brains of those experiencing them are still active. Covert cognition fills many blanks.

My OBEs felt like imagined perspective shifts, but the sensation of floating outside your body can be electrically stimulated in the brain (Blanke and Arzy 2005). Furthermore, REM intrusion, which causes blended dream states like lucid dreaming, may be responsible for the fantastical qualities of NDEs (Nelson et al. 2006). “I see it [the NDE] as an activation of certain brain regions that are also active during the dream state,” said Nelson. The study adds, “Under circumstances of peril, an NDE is more likely in those with previous REM intrusion.” I sometimes lucid dream spontaneously, as I did in the coma-dream. The hallucinations James Randi has reported seeing while awakening from surgery were probably due to REM intrusion.

While I was comatose, Keith told me about his future plans for us, most of which I remembered when I awoke. He would start telling them again, and I would say, basically, “Been there; heard that,” albeit through his doppel­ganger. Yet, at the same time Keith was telling me these things, the doctors were advising him to give up hope that I would ever fully recover. Indeed, they said rehabilitation of any sort would be futile, despite the fact that every time I experienced a new stimulus my wakefulness improved. I can’t help wondering if medically supervised stimulation might have helped me emerge from the PVS sooner—as happened with Kate Bainbridge after she was “found.” It would’ve certainly shortened my recovery. Instead, I was written off as a basket case after the MRI, which, ironically, may have jumpstarted my awareness like a dead car battery. It’s the earliest event that appeared in the coma-dream, and after the stress of the scan, I displayed new hints of arousal.

Today, I have no signs of cognitive impairment, nor have I since that first conscious moment. How embarrassing for the doctors who wrote me off. Indeed, I don’t believe I was even in a coma when I regained consciousness. The comatose don’t have sleep-wake cycles, which is why their eyes remain closed. So, I was vegetative, but not under the restrictive Merck Manual definition. Ms. Bainbridge wasn’t misdiagnosed; she fit the criteria for PVS. It’s the term that needs revision.

I used to feel sorry for people clinging to the desperate hope that their vegetative loved ones would recover. I still feel sorry for them, but their hope no longer seems so hopeless to me. I worry that life-and-death decisions are being made based on inadequate testing and incomplete knowledge. Ms. Bainbridge and others who were in the same situation have expressed similar concerns. Nurses gently suggested to my mother that my quality of life was poor, which she took as a hint that I should eventually be taken off life support.

Vegetables rarely write articles, however. My recovery is still ongoing—I was so deconditioned after the long period of complete inactivity I could barely lift my head—but my quality of life is excellent. In fact, I feel an increased sense of purpose and self-confidence. Though I don’t believe my recovery was a gift from God, I do view my second chance as a gift.

And speaking of gifts, last Christmas, Keith and I walked into the ICU with a gift basket to thank the medical personnel who saved my life. Some of them didn’t recognize me upright. On the basket, we taped a collage of pictures taken during our strength-building walks. Many of the ICU workers cried; some said my recovery was a miracle. But it was no act of God that saved my life—it was science. Massive doses of antibiotics scrubbed the Legionella from my system like an antivirus program (or should I say antibacterial program?), halting my septic shock. A respirator and dialysis bought my failing organs time, and they gradually came back online. And, after six weeks, my brain finally rebooted. The human body is a marvelously evolved machine, even though, with my bad back, I often wonder if bipedalism was such a good idea.

The doctors and nurses taking care of me were responsible for giving me this second chance, and for that I’m obviously grateful. But maybe we should be giving more respect to the amazing resilience of the human brain and be more humble about the limits of our knowledge about it. And while we’re at it, let’s not underestimate the boundless powers of imagination, where polar bear cubs churn ice cream with Big Wheels and where flying somewhere over the rainbow doesn’t require an out-of-body experience.

References

Blanke, Olaf, and Shahar Arzy. 2005. The out-of-body experience: Disturbed self-processing at the temporo-parietal junction. Neuroscientist 11(1): 16–24.

Finns, Joseph J., and Nicolas D. Schiff. 2010. In the blink of the mind’s eye. Hastings Center Report 40(3): 21–23.

Maiese, Kenneth. 2014. Vegetative state and minimally conscious state. Merck Manual Professional Version. Online at http://www.merckmanuals.com/​professional/​neurologic-disorders/​coma-and-impaired-consciousness/vegetative-state-and-minimally-conscious-state.

Monti, Martin M., Audrey Vanhaudenhuyse, Martin R. Coleman, et al. 2010. Willful modulation of brain activity in disorders of consciousness. New England Journal of Medicine 362: 579–589.

Naci, Lorina, Rhondri Cusack, Mimma Anello, et al. 2014. A common neural code for similar conscious experiences in different individuals. Proceedings of the National Academy of Sciences of the United States of America 111(39): 14277–14282.

Nelson, Kevin R., Michelle Mattingly, Sherman A. Lee, et al. 2006. Does the arousal system contribute to near death experience? Neurology 66(7): 1003–1009.

Owen, Adrian M., Martin R. Coleman, M. Boly, et al. 2006. Detecting awareness in the vegetative state. Science 313(5792): 1402.

For a few weeks this summer, I vacationed in a part of the country I had not visited before: an area high in the hills west of Los Angeles. In the late 1960s and early 1970s, this region was home to an enclave of hippies, including some of the rock stars of that era.

Today’s visitors to this rugged landscape feel like they have slipped through a portal into an earlier time. The locals have adopted the trappings of the contemporary world, but many signs of the sixties still remain. Long hair and flowery costumes are popular. Tobacco smoking is relatively rare, but pot smoking is not. Yoga studios are everywhere, and shops are perfumed with the smell of incense.

I spent some time at a local coffeehouse that provided a vivid introduction to the local culture. The staff and patrons were very friendly, and many of them were artists of one kind of another. Because it was summer, tanned children and affectionate dogs often passed through. Out on the patio, there was a sign that said “No Smoking Anything,” and there were regular discussions of the upcoming Burning Man festival. The environment was quite welcoming, and the coffee and pastries were delicious. So I spent many happy hours there.

But the culture of the place was also an incubator for non-scientific thinking. One morning, a single overheard conversation touched on vegan dog foods, worries about vaccinations for both dogs and children, and a friend who was away having a mercury detox treatment. Among the products for sale at the coffeehouse were a book called “The Children’s Guide to Astral Projection,” decks of “Angel Cards,” and love potions—$20 for a (very small) bottle. During another overheard conversation, a patron espoused the view that marijuana provided protection against several diseases, and one night during my stay, the local library had a showing of an anti-vaccination film ($10 suggested donation).

Although we often talk about the Republican War on Science, this was liberal anti-science territory. Hybrid vehicles were very popular (translation: concern for the environment), but the most common bumper sticker on those cars expressed opposition to GMOs. The only political candidate whose name I heard was Bernie Sanders, and I heard his name almost every day.

However, it would be a mistake to think of this as a political war—or even a war at all. Whereas Chris Mooney’s 2005 book detailed an organized conservative campaign against science, my California experience was something quite different—a fairly coherent culture that includes both pro- and anti-science viewpoints.

The New New Age

The New Age Movement has been around so long that it is undeniably old. Although it has earlier roots, it gained popularity in the 1960s and 1970s and continues to this day. Among other features, New Age ideas are characterized by a rejection of traditional religion and medicine and strong support of the environment. But what was once a kind of grassroots extension of Haight Ashbury and the flower power revolution has now been swallowed up by a twenty-first century marketing strategy.

In 2000, the husband and wife team of sociologist Paul H. Ray and psychologist Sherry Ruth Anderson wrote a popular book entitled The Cultural Creatives: How 50 Million People Are Changing the World. They argued that the descendants of the New Age Movement had matured into a growing population of “Cultural Creatives,” whose values separate them from “Traditionals” on the one hand and “Moderns” on the other. Some of the values that distinguish Cultural Creatives from others are listed in Table 1.

Table 1

Source: Ray, 2008.^[1]

According a 2008 report by Ray—who is identified on the document as the Research Director at the Institute for the Emerging Wisdom Culture at Wisdom University^[2]—Cultural Creatives had by then increased to 35 percent of Americans.^[3]

As far as I can tell, Ray and Anderson’s work has not been submitted to peer review, and the survey results used to bolster their classification scheme appear to be drawn from proprietary marketing data. This research approach makes sense because Ray and Anderson’s concept of Cultural Creatives was quickly used to identify a group of consumers called Lifestyles of Health and Sustainability (LOHAS). Once identified, consulting and marketing firms popped up to help producers take advantage of what has been estimated is $290 billion market.

Table 2 is reproduced from the website of LOHAS Group, a consulting firm in Boulder, CO.

Table 2

Source: LOHAS Group Consulting Firm, http://www.lohas.com/about.

Science-minded people will have no objections to most of Table 2. We are concerned about the environment, and we are pleased to discover that Cultural Creatives are not climate change deniers. This is a good thing. But the most lucrative segment of the LOHAS demographic—personal health—is a problem area. “Natural” is a nice sounding word, but much of what is marketed as natural is pseudoscience. In addition, many mind-body-spirit products make superstitious claims (e.g., love potions).

To make matters worse, some of the recommended strategies for appealing to the LOHAS group are pointedly anti-science. The figure below comes from consumer research done by marketLOHAS, a marketing firm aimed at targeting the LOHAS consumer. The clear implication of this graphic is that labeling a product “non-GMO” will lead to more sales than labeling it “organic.” If true, this is a demoralizing statistic. Furthermore, companies that adopt this advertising scheme will make it more difficult to counteract popular misunderstandings about genetically modified foods.

By the way, according to their website, marketLOHAS has worked with Whole Foods, Honest Tea, Unilever, and many other companies. As a result, we can look forward to seeing more products labeled “non-GMO” at Whole Foods and elsewhere.

Fighting a Culture War

It is hard to say whether Cultural Creatives or the LOHAS market are meaningful concepts, but the targeting of a group for marketing purposes can only help to solidify it and give it a sense of reality. Furthermore, the Los Angeles area coffeehouse culture I experienced seemed fairly well developed. People appeared to gain a sense of community from a loose set of shared beliefs and attitudes. Furthermore, this contemporary version of New Age thinking is by no means restricted to California. Most of us run into it fairly regularly, no matter where we live.

All of this suggests that perhaps we have been taking the wrong approach in our attempt to promote critical thinking. As people who value rationality and argument, skeptics have tried to attack pseudoscience, superstition, and unreason by force of logic and evidence. We look at the data, and then try to make a logical argument in light of that data. We usually have a good case, but all too often our efforts fail to produce the desired effect. Superstition and unreason continue unabated.

Similarly, psychological science has often taken a fairly micro-level approach to figuring out why people believe irrational things. For example, in a 2006 study of Finnish college students, Marieke Saher, Marjaana Lindeman, and Ulla-Kaisa Hursti found that being a natural science student was strongly related to not having negative attitudes towards GM foods.^[4] Furthermore people with intuitive thinking styles were—as we might expect—less likely to be natural science majors. Finally, students who endorsed an “ecological and humanistic self-transcendant value system”—which sounds like it should be a good thing—also had more negative attitudes towards GM foods.^[5]

All of that is useful information, but after my California vacation I realize that these intuitive, non-scientific thinkers with self-transcendent values are not just randomly distributed throughout the population—they are hanging out together at the coffee shop. And not just at the coffee shop: the yoga studio, the natural food store and/or restaurant, and the spirit stores.^[6] There is a collection of social and commercial institutions that provide meeting places and shared support for a wide variety of New Age ideas—some of which are deeply anti-scientific. These people have enough of a cultural framework that they can easily find each other.

This leads me to the idea that much of our approach to anti-scientific thinking has overlooked the cultures in which it grows. I don’t think it would be a wise strategy to attack New Age culture in general. When we are on the offensive, it is much more productive to narrow our criticisms to specific New Age beliefs, and it seems to me we already know how to do that.

What’s lacking is a different kind of effort aimed at creating a positive culture of skepticism, science, and reason. LOHASers, Cultural Creatives, and New Agers have their coffeehouses. Where are ours?

Hanging Out at the Science Café

It has often been pointed out that atheists have no institutions to rival the various communities of faith around the world. Similarly there are few signs of a pro-science culture. Scientists can be found in the laboratory and on university campuses, but where do they hang out after work?

No place in particular.

We have our skeptic groups and conferences, but these are not yet mainstream events. There is by now a worldwide network of “Skeptics in the Pub” groups, but I haven’t heard about any permanent skeptic’s pubs—ready to welcome you at any time. Perhaps we need our own marketing firm that will identify a segment of the economy known as “Lifestyles of Science and Reason” (LOSAR) and begin to market products to us.

Because I often frequent coffeehouses, I would be particularly grateful for a chain of science geek java houses. Each store would have fast wifi, great coffee and food, science books for sale, beautiful astronomical and nature photos on the walls, book discussions and science talks on Sunday nights, and perhaps even an observatory on the roof. The café would serve beer and wine in the evening, and it would be open all night whenever a meteor shower was expected. Perhaps on Thursday nights there could be a science trivia competition. It could be an amazing place.

Everything we do now to promote scientific thinking is great. And perhaps it is too soon to begin marketing products aimed to the LOSAR segment of the economy. But it would be wonderful to see more places where science-minded people can meet casually away from work, where science-based social activism can be fostered in a fun and welcoming environment, and where the general public could be exposed to the cooler parts of being a science geek.

If it happens, I promise to show up for trivia night.

^[1] http://www.wisdomuniversity.org/CCsReport2008SurveyV3.pdf

^[2] Wisdom University is now the Wisdom School of Graduate Studies at the for-profit Ubiquity University in Mill Valley, CA. http://www.wisdomuniversity.org/index.htm

^[3] http://www.wisdomuniversity.org/CCsReport2008SurveyV3.pdf

^[4] Saher, M., M. Lindeman, and U.K. Hursti. 2006, April 30. Attitudes towards genetically modified and organic foods. Appetite. doi:10.1016/j.appet.2006.01.015.

As a side note, I want to point out that Marjaana Lindeman and her students at the University of Helsinki are some of the best and most active researchers on paranormal and pseudoscientific belief working today.

^[5] The role of intuitive thinking in negative attitudes about GM foods has been confirmed by a recent study by Belgian researcher Steffan Blancke and colleagues. http://www.scientificamerican.com/article/why-people-oppose-gmos-even-though-science-says-they-are-safe/

^[6] Spirit stores are indeed a thing. For fun, go to Yelp.com, use “spirit store” as a search term, and see what pops up in your area.

“You should freeze your toxins out!”

The emails were adamant. Everyone wanted me to undergo cryotherapy: step into a -260°F stall, alone and naked, for three minutes, and feel the toxins flutter away into the ether.

No thanks, I thought. I am a cold wuss. I grew up in Los Angeles, where anything below 80°F is cool and below 70°F is downright cold. Not to mention that even here in Hollywood, I am always the person to ask whether anyone has an extra sweater before we go into an air-conditioned movie theatre. I didn’t seem like a good candidate for experimental hypothermia.

Yet we got the request so many times that my curiosity grew. The frightening-sounding treatment has been on the rise the last few years, with The New York Times noting the increase in athletes who used it in 2011. Since then, companies offering the service have sprouted up, especially in Los Angeles, where alternative therapies abound. Earlier this year, The Atlantic released a video about their medical-doctor-turned-editor-in-chief trying out cryotherapy. He was willing to do it, despite the practitioner telling him that some brave partakers got frostbite. If a doctor could summon the courage, couldn’t I? With a little encouragement from my podcast host Ross, and seeing that the whole experience totaled out at three minutes, I decided to give it a shot, even though those three minutes would cost $65.

I showed up at Cryohealthcare in West Hollywood at 11 a.m. The storefront was relatively unassuming, bearing just the word “CRYO,” and one window postered with a photo of a man looking powerful and manly as he exited a cryochamber next to billowing fog. As I entered, a blonde Caucasian woman greeted me from behind the counter. She was surrounded by sleek, white, ultramodern fixtures. The entire place felt at once spa-like and dystopian, like a plastic surgeon’s office in a movie set in 2050.

“What are you here for today?” the clerk asked.

“Whole body cryotherapy,” I said, nervously. “But my friend is coming!” I added, hoping Ross’s absence would buy me a few minutes.

“Well, you can get started on the forms,” she said. The high-tech atmosphere left no room for silly things like paper and pens, so she handed me an iPad and had me read the various required warnings. I was not to do cryotherapy if I had Reynaud’s Disease (extremely low blood flow to the fingers and toes) and other conditions that would mix badly with, say, sub-zero temperatures. Claustrophobia was also a no-go, as were pacemakers and tumors.

Once Ross arrived and began filling out his own releases, a woman in all white came to take my blood pressure. The good news, she said, was that first-timers stayed in the chamber for a shorter time: men for two minutes, women for ninety seconds. Deeming me safe to freeze, she sent me into the next room, followed by Ross.

The all-white decor continued, with various Caucasian, blonde women calmly escorting guests in and out of dressing rooms. I was sent into a small changing stall and told to put on a robe and thick, knee-high socks. I was to remove everything under the robe, while Ross was told to leave his underwear on (presumably to protect, and I think this is the scientific term, his hanging junk). Inside the private stall, I took a photo of my nervous face, dreading what was to come. I hadn’t slept nearly at all the night before, and the dark circles under my eyes commingled with the fear in my eyeballs.

I got in line with Ross, watching as others entered and exited the “cryochamber.” There was only one chamber, allowing the attending staff to give their full attention to whoever was inside. Everyone ahead of us in line had gone through the procedure before, so they exchanged brief words with the woman working the machine, entered the small dressing room attached to the chamber, and once disrobed, gave a wave to the technician from a window at the top of the stall. One hundred and eighty seconds ticked down as the victim chilled inside. One by one, they exited the stall, happy and invigorated. Some went straight for the elliptical machine to warm up their muscles before returning to their cars. Others gave a quick thank-you and left. No one seemed to be reacting normally: screaming in pain as their body turned to human ice.

As instructed, I finished my preparations by donning a face mask, gloves, and rubber clogs. It was my turn.

“This is my first time,” I told the technician, “So just ninety seconds, right?”

“Yes,” she said, “And what song would you like?”

I hadn’t known we could pick a song.

Something warm, I thought.

“Here Comes the Sun?” I shrugged, smiling meekly at my own joke.

“Here—what?”

“Here Comes the Sun?” I nodded, certain that she must know it. “It’s The Beatles?”

“Oh,” she said, and entered the title. “Ready?”

“Sure,” I lied.

I entered the dressing room, and a massive door settled shut behind me. Even the dressing room was too cold for putting on clothes, much less taking them off. I quickly disrobed, then, urging myself to waste no time, opened the meat-locker-style door, and entered a wall of fog so thick a murderer could have been standing behind it, and I would have walked right into her arms.

For a moment, I panicked. I hadn’t given the technician the thumbs-up sign. What if she hadn’t started the timer, and I was wasting precious seconds, encased in a dry ice machine? But the music started, and I knew she had begun. A creepy rendition of “Here Comes the Sun” started playing. It was happening. I was freezing my toxins out.

With not an inch of sight in front of my face, I immediately went into survival mode, clinging to my naked breasts and covering my nipples, then hunching slightly to protect my exposed crotch.

Just stay alive, I thought.

The cold was so extreme that my body didn’t seem to know what to do with it. Without the accompanying moisture it was used to in low temperatures, the icy air was prickly and remote, not settling in on my skin, as if the cold and I were being repelled like magnets. It was cold, but the cold somehow couldn’t reach me, inside. Fear and survival kept me warm. I felt my nipples turn rock hard, squeezing into a painful point. My eyes began to dry up, and the thin layer of snot lining my nose turned into icicles, poking my septum. It was an eerie analog of death, with little of the accompanying pain and panic. My basal temperature had no time to fall before the final countdown began.

“Thirty seconds remaining,” a robotic woman’s voice said.

I braced myself, trying not to count down with her. I knew that the seconds would seem much longer against my own racing brain.

“Twenty seconds remaining.”

I wondered how anyone could do this for a full three minutes. Didn’t they treasure their life, as I did? I was definitely going to read Infinite Jest.

“Ten seconds remaining.”

If I got out of this, I would tell everyone I loved them, every single day. Even if I didn’t.

“Five seconds.”

Maybe my mom was right about me being a psychologist. It’s not too late. Besides, I had a psychology minor in undergrad. Just a few more classes, and—

“Cooling complete.”

I burst out of the chamber, pushing the door with all my might. The apparatus is designed to allow exit at any time, even for the weakest of clients. It swung easily open and I tumbled out, nearly hitting the wall on the other side of the dressing room. I quickly put my robe on and thrust the dressing room door open. The technician looked at me, wide-eyed, for signs of panic. I must have passed the “alive” test, because she nodded casually and grabbed an infrared thermometer.

“Stay there; I have to take your skin temperature,” she said.

She measured the temperature on my lower shin.

“97.8,” she said. “You’re fine.”

“Hey! How was it?” asked Ross, eagerly waiting outside for my return.

“It’s okay. It’s okay,” I nodded. “It’s cold.”

“You next?” the technician asked him.

“Yep!” said Ross, eagerly stepping into the chamber. His two minutes passed in no time.

When we left, we noted the things we had that were supposed to improve in the next few days: my headaches (ever present), my recent insomnia (caused in part by worrying about cryotherapy), and Ross’s sports injuries. A few days later, we compared notes. Ross’s injuries were about the same. My headaches hadn’t improved. But I had slept like a baby that night.

I haven’t cracked open Infinite Jest.

I blame Tim Farley, the skeptic who runs the website whatstheharm.net. We were both on a skeptic-themed cruise when he gave a talk about finding a direction for your skepticism. He pointed out there were numerous blogs about skepticism in general, but that it could be even more helpful
 to specialize. My history of skeptic activism had been simply answering UFO questions for a few years via several online “answer” sites. Before Tim’s talk, I had never considered an approach that would be more akin to outreach.

What followed was increased interaction between myself and the “UFOs are aliens” community. I started the infamously poorly designed website, badalien.org, which has proven highly popular with those who feel they might have been abducted by aliens. I found myself in the position of often being the only skeptic among many believers at UFO conferences, the Lone Ranger of rational thinking in a wild west of irrationality.

My first impression was “I like these people.” The result of this unexpected likability of the UFO and alien believer crowd inspired me to assemble a team of volunteer experts, including therapists, a psychiatrist, several medical doctors, and other volunteers to help me better educate these believers in critical thinking skills. The skeptics who volunteer their time to help me help others are the real force behind the alien abduction work I enjoy. I found there are many UFO and alien believers that are tortured by the belief that they have been abducted by aliens, or those who feel UFOs are zipping about the skies where they live with evil intentions. Others find they enjoy believing they have been abducted and only want assurance that they are not being “irradiated” or otherwise harmed as they travel planet to planet. It’s a blessing or a curse, but either way, these people want and need someone to share their experiences with. If the only people listening are non-skeptics, then they never have a chance to learn some valuable critical thinking skills.

I do not like the unlicensed therapists touting hypnosis at a high fee to help people “remember” their abduction experience. There are far too many people willing to take advantage of believers in the paranormal. I know anyone can call herself a “therapist” and charge whatever she likes to treat almost anything; trust me, it’s probably not going to be covered by insurance. Real therapists, since the landmark case in which Nadean Cool sued her psychiatrist for implanting false memories in 1997, are far more careful about their use of hypnosis to “recover memories.” Among UFO therapists that have just hung out their shingle, hypnotism remains an important “tool.” How else can you convince someone that has had some disturbing dreams, or perhaps vague memories that he or she has been abducted? Then these therapists, who are the real “tools” here, can start charging money. I have to admit, the dislike goes both ways. Skeptics are seen as a danger to their ability to scam money from the credulous. The farther these scam artists can keep skeptics from believers, the better for their bottom line. This is probably one of the most important reasons skeptics need to interact with believers. It pisses these people off to be challenged, and the only people truly challenging them are skeptics.

I often wonder if Betty and Barney Hill would ever have sued Dr. Benjamin Simon, the doctor who, through the use of hypnosis, brought out the details of their supposed UFO abduction. The problem was Simon believed their recollections were a fantasy, while the Hills held firm that their recovered memories of abduction were real.

I truly enjoy being part of a team helping people suffering from a belief that they have been abducted by aliens find the help they need to live better quality of lives. Please note, I don’t say “Drop their false belief they have been abducted by aliens.” Many people, often surprisingly quickly, lose their belief. In fact, sometimes people who contact me write “I think I’ve been abducted by aliens, and that can’t be true. Help me prove it!” The skeptic team I rely on joke that I am “triage.” I simply point people in the right direction. I admit for the most part I just read a lot of long emails and reply with respect, sympathy, and most importantly hope. The satisfaction I have gained from this work made me open to more experiences working with other people, perhaps best described as lacking in critical thinking skills.

I recently started helping in a small way with the local Bigfoot group. These groups are popping up all over the United States, inspired by reality TV shows of people calling themselves “experts” tromping around the woods and making a lot of noise. The formation of our very small local group was simply based on a group of local hunters saying, “Well I can do what those people on TV are doing.” They did decide they needed a “skeptic,” for which I thank reality TV. The token skeptic on most reality shows has made it fashionable to have a skeptic on board. I would like to point out that I did use the word fashionable, not in any way to describe how the average Bigfoot hunter dresses. I include myself; Bigfoot hunting is about being outdoors, not about looking pretty.

There are two problems with a Bigfoot group having me as the token skeptic. For one thing, I’m not able to keep up with the local group made up of very strong outdoor hunters. Still, I offered to do my part via our chat meetings (we are indeed “high tech”) and helping look for Bigfoot in my own backyard. I live in rural New Hampshire, where there have been Bigfoot sightings locally, so this wasn’t a problem. I believe Bigfoot has now been sighted not only in the forty-eight continental states but also is starring in an off Broadway production of Rent.

The second problem is I am a real skeptic. I should modify that to say I am not a TV reality show skeptic. This consists of me saying more than “Well, I’m still not convinced.” The group is made up of wonderful young men who perhaps are more respectful of me challenging them because I remind them of their mothers. I do honestly appreciate their careful consideration of my suggestions. The ideal skeptic for the group to have would be a trained biologist with critical thinking skills. The problem is most biologists are busy making a living being biologists. The commitment of even the small amount of time a Bigfoot group takes is too much for most biologists to commit to. The group gets my critical thinking skills, and my connections to many good-natured scientists willing to answer questions like “Why are there so few bipedal large mammals?” and “How would you expect a large ape-like mammal to smell?”

There is an old skeptic saying “You can lead believers to knowledge, but you can’t make them think.” However, as with my UFO believers, what I find works best is not my leading them to knowledge but my suggesting a path for them to find the answer themselves. No one wants to be just told they are wrong. It’s always easier if they find out through critical thinking skills you have helped them learn that perhaps they were mistaken, or should investigate some more before petitioning to have Bigfoot listed as an “endangered species.” If someone finds out they were wrong on their own, it gives them a chance to put a “spin” on it. They weren’t “wrong”; in fact they usually are happy to show off their newfound knowledge to the skeptic know-it-all. I was pleased when a UFO believer showed me recently how that “face on Mars” is just a “funny rock with some shadows.”

Teaching critical thinking skills requires a two-way street of respect to be established. Sometimes you have to play by their rules. My Bigfoot group came up with a very clever plan to find Bigfoot prints. They decided that since the Bigfoot is related to the Yeti, Bigfoot must leave footprints in the snow in winter. Thus, Bigfoot snow scanning was born! I did have a little skeptical talk with the group about how it is stretching things to find a relationship between two creatures that only exist in the dreams of cryptozoologists. The group at least listened to my explaining why you can’t compare two unproven creatures. I pointed out it would be like saying “Unicorns are related to Pegasus!” They took this well, as I had agreed to participate in their exciting plan to prove Bigfoot, snow scanning.

Snow scanning was their inventive plan that simply means that each of us would look at a given area of land every single day in winter, with no exceptions. When I was ill, I would make sure my plot was covered, and I also took part in a bigger weekly scanning of local Pisgah State Park. We were vigilant. I had simply to look out over my backyard, which covers several acres. If you live in Florida, you may be confused by the logic of this. Those who live in Northern climates know their snow cover lasts for months. The snow cover doesn’t melt until spring, which results in not only spring flooding but also a whole lot of months for Bigfoot to leave tracks in the snow.

I was careful, despite my lack of belief in Bigfoot, to do my required scanning. I was the only member to find still unidentified tracks in the snow. This was slightly shocking to the group, that the skeptic found the only unknown tracks. It proved I was “on board” and also made them more open to my suggestions. They finally understood I wasn’t there to “cover up” Bigfoot evidence and was playing “by the rules.”

I have to admit, the results of my suggestions aren’t always quite what I expect. I sometimes give the group “homework.” I asked them to consider the mystery of just why Bigfoot isn’t sighted more on trail cameras and why the photographs are so bad.

As a skeptic, I find it mysterious also that a video or photograph that is close up and in focus is almost always labeled a “hoax” even by believers. It’s as if we’ve come to expect photographs of the paranormal to be of poor quality. I put the problem to them, hoping they might begin to edge toward the suspicion that there just might not be a Bigfoot, at least here in rural New Hampshire. I do not have proof there is no Bigfoot. There will always be another tree to look behind. I just want the group to be open to the possibility that their vague sightings (and personal experience is a bitch to break, I’ve found) might just have another explanation. 
The results of my “homework” were good in that some real thought had gone into the answers given. The problem was that their answers were less than the skeptical answers I was hoping for. The group felt that Bigfoot could sense batteries. What do trail cameras, regular cameras, cell phones, and Jim’s new pacemaker have in common? A battery. Their hope was that if we went into the woods with no electronics—and Jim stays home with his new pacemaker and Tim leaves his hearing aide at home—we might see Bigfoot. Alrighty then. I rolled my eyes, but they were willing to accept my eye rolling. Many of them have teenagers at home, so they are used to it.

The problem, I pointed out, is that we would be left with only personal testimony yet again. Then one member came up with the idea we should take “old fashioned cameras.” This means that soon, a group of men will be tromping through the woods of New Hampshire, holding Brownie style Kodak cameras, wondering why Bigfoot doesn’t show up. I agreed to go along with the photography plan, but several members of the group are also investigating just how Bigfoot might sense a battery. It’s baby steps, but I have to admit that going around the forest with a vintage camera and old-school film is going to be rather fun.

Another question the group often debates is whether Bigfoot should be shot or not. Not being a believer, I said “It would be definitive scientific proof, go ahead.” This has since been changed to “Idiots will pretend to be Bigfoot, please don’t shoot a stupid human even if their death might enrich our gene pool.” If nothing else, my belonging to this group may save the life of an idiot in a Gillie suit.

The principal quality required of any Lone Skeptic is patience. When the cameras fail, and I am ever hopeful and would be happiest if we did indeed photograph a Bigfoot, the group will revisit the topic. This group is thankfully one that does not believe Bigfoot has any great paranormal abilities, and that Bigfoot hunting should not be thrown in with ghost hunting or alien abduction. This small group truly believes Bigfoot is a real creature whose existence can be proven with the same methods used to prove the existence of the Mountain Gorilla.

I have pointed out that while the Mountain Gorilla was discovered in the West only in 1902, I’m willing to bet the locals knew all about it for much longer. We are in this case the locals. It’s up to us neither to prove nor disprove. I hope I can continue to raise doubt, and at least some of the group will come away with new critical thinking skills. If the group reaches the conclusion that here in our corner of New Hampshire, despite some scary personal encounters, there is not a large bipedal ape-like creature living in the forest, I will feel truly successful. That’s about as good as skepticism gets. Right now I feel the answer to the question of whether Bigfoot lives in New Hampshire is “no.” I assure the group, bring me a dead body of a Bigfoot, and I’ll make that a “yes.” However, that also goes for unicorns and fairies. Science demands proof. Of course the most important thing isn’t whether there is a Bigfoot or not; it’s the critical thinking skills the group is learning. TV skeptics just shake their heads and wait to be convinced. I jump right in and try to provide evidence to the group that there isn’t a Bigfoot nearby. It’s a two way street, a respectful exchange of ideas and learning. If nothing else, I learned what poison ivy looks like, and the group was kind enough to keep me from sitting down in a patch of it.

I am often asked, when dealing with believers in alien abduction and Bigfoot, just why people believe in these unproven entities. Most of the believers aren’t crazy, though my own work suggests many of them, while not meeting the medical diagnosis for insane, often are what most of us might consider a little quirky. Remember, I’ve been to a couple of Comic Cons, so I know quirky.

One thing many paranormal hardcore believers have in common I can best describe as “trust issues.” It seems at first as though they simply mistrust science and the government. Science and the government are helping hide the truth, whatever they might believe to be truth, from the rest of us. Believers often don’t personally know many people who work for the government or who are scientists. Despite the likes of Stanton Friedman, a physicist with degrees from the University of Chicago and a self-described UFO “expert,” the fields of paranormal research are sadly lacking in scientists. That’s why it’s often up to a non-scientist such as myself to step up and try to work with paranormal groups. Personally, I’d rather scientists keep doing science. I truly respect science professionals who take time out of their busy lives to help the skeptic community battle misinformation. My own daughter has a PhD from MIT, but she’s too busy doing real science to have much time left over for battling pseudoscience.

Along with science, the government is not to be trusted. This is especially true for the UFO community. It’s hard to accuse the government of covering up Bigfoot, when they are supposedly walking around in our backyards. Still, government distrust rarely takes into account that even the most top-secret facility hiding aliens and UFOs has to have someone empty the waste baskets and clean the floor.

The point is that secrets are hard to keep. It was especially fun when, via a skeptic website, I met someone who worked at the Wright Patterson Air Force Base in Ohio. I asked him if he was the one who made sure the freezers where the aliens were stored were kept running. He thought it was hilarious when I sent him some of my business cards that ask “Do you think you have been abducted by aliens?” to leave around the base. He actually did place them around the base, and since he was a civilian worker not a member of the Air Force he said he “got away with it.” It seems even the government will tolerate a joke every now and again.

So who do these people trust? They are the Libertarians of science. “I know what I’ve seen and I trust myself.” The words “I know . . .” come up over and over. “I don’t care what those scientists say, I know what I’ve seen.” Personal experience trumps all. They also trust other people who support their paranormal beliefs.

Sometimes there is also a feeling of “I don’t trust medicine,” meaning mainstream science-based medicine. There are tales of “She went in for an operation, and the hospital killed her.” I have found over the years this can mean anything from death of natural causes to a resistant infection picked up while recovering from surgery. Sadly, medicine will always fail in the end, and only alternative medicine promises “Trust me, I promise 100 percent to cure you.”

This lack of trust often comes from a lifetime of learning not to trust others. Many have belonged, or belong to, churches with a strong emphasis on “You can’t trust anyone but your pastor.” Early emphasis on “you can only trust me,” whether it be a pastor, parent, or group, enables the believer to be open to conspiracy theories. Distrust of science and government is learned early, often at the foot of a parent or pastor. I know many skeptics who claim “I don’t trust anyone; I like to investigate and come to my own conclusions.” If simple distrust of everyone were taught, most children would grow up to become skeptics. Instead, at some point, a mentor or important figure in their lives taught the believers I’ve met to put their trust in the wrong people. It is never, “Don’t trust anyone.” It is instead, “Just trust me.”

I feel that this teaching of distrust of others is a way to exercise power and control. A religious leader who teaches “You can trust only me” is enabled to control his congregants. A parent who teaches his child to not trust others has more control. Alternative medicine providers need to instill distrust of mainstream medicine before they can sell their products. If a cult wants you to join, the first step is often teaching that others not in the cult cannot be “trusted” and often those not to be trusted include close family and friends.

This doesn’t make the believer bad or stupid; it simply means skeptics have to help them learn to trust the right people. There are degrees of course. One member of the Bigfoot group I belong to is a nurse. He trusts science but doesn’t have enough critical thinking skills yet for him to admit Bigfoot is probably not a real creature. His science education makes him more open to my skeptical suggestions, despite his own purported sighting of a Bigfoot as a child.

Meanwhile, I enjoy participating and working with these believers because they are interesting and often open to learning. I’m a teacher in my heart, and I find the possibility of teaching even one person a few new skeptic skills reason enough to interact with believers. I also find, like any good teacher, that I learn much from those I am attempting to teach. A good teacher is also always a student. The more I interact with believers in Bigfoot and aliens, the more I learn how to understand and perhaps help change their beliefs. If nothing else, I learned long ago that most paranormal believers have a good sense of humor about what they believe, as well as being far more open minded than most skeptics believe.

I try to remember when I believed in the Loch Ness monster because of the wonderful flipper photograph taken at the loch in 1972. My biology teacher in Middle School did not just laugh at me when I told him “Nessie is real!” Instead, he assigned me homework to study just how big a breeding population would need to be for the monsters, and what kind of diet was available for them in Loch Ness. I sadly reported to him days later that obviously there was “Something wrong with that photograph.” He changed my mind not by laughing at me but by pointing me in the direction needed to discover the answer for myself. It was a lesson also in how to be respectful of the perhaps wrong beliefs, while also teaching critical thinking skills.

I sometimes think of the old saying “Give a man a fish, he eats for a day; teach a man to fish, he eats for a lifetime.” I like to update it to “Give a person an answer, they will know Bigfoot isn’t real. Teach a person skepticism, and they’ll think Bigfoot isn’t real, aliens aren’t visiting from Venus, and they’ll vaccinate their children.” It’s not just what you believe about the paranormal that changes when you learn Bigfoot probably isn’t real, it’s how you live your entire life that changes for the better.