The recent medical controversy over whether vaccinations cause autism reveals a habit of human cognition — thinking anecdotally comes naturally, whereas thinking scientifically does not.

On the one side are scientists who have been unable to find any causal link between the symptoms of autism and the vaccine preservative thimerosal, which in the body breaks down into ethylmercury, the culprit du jour for autism’s cause. On the other side are parents who noticed that shortly after having their children vaccinated autistic symptoms began to appear. These anecdotal associations are so powerful that they cause people to ignore contrary evidence: ethylmercury is expelled from the body quickly (unlike its chemical cousin methylmercury) and therefore cannot accumulate in the brain long enough to cause damage. And in any case, autism continues to be diagnosed in children born after thimerosal was removed from most vaccines in 1999; today trace amounts exist in only a few.

The reason for this cognitive disconnect is that we have evolved brains that pay attention to anecdotes because false positives (believing there is a connection between A and B when there is not) are usually harmless, whereas false negatives (believing there is no connection between A and B when there is) may take you out of the gene pool. Our brains are belief engines that employ association learning to seek and find patterns. Superstition and belief in magic are millions of years old, whereas science, with its methods of controlling for intervening variables to circumvent false positives, is only a few hundred years old. So it is that any medical huckster promising that A will cure B has only to advertise a handful of successful anecdotes in the form of testimonials.

Take wheatgrass juice … if you can stomach it. The claims for its curative powers bottomless. According to the Natural Medicines Comprehensive Database (the “bible” of natural medicines), wheatgrass is “used therapeutically for increasing hemoglobin production, improving blood sugar disorders such as diabetes, preventing tooth decay, improving wound healing, and preventing bacterial infections.” And that’s not all. “It is also used orally for common cold, cough and bronchitis, fever and colds, inflammation of mouth and pharynx, tendency to infection, gout, liver disorders, ulcerative colitis, cancer, rheumatic pain, and chronic skin problems.”

The alleged salubrious effects of wheatgrass were promoted in the 1940s by a Lithuanian immigrant to Boston named Ann Wigmore, a holistic health practitioner who was inspired by the biblical story of King Nebuchadnezzar, recounted in Daniel 4:33, in which “he was driven from men, and did eat grass as oxen, and his body was wet with the dew of heaven, till his hairs were grown like eagles’ feathers, and his nails like birds’ claws.” Wigmore also noted that dogs and cats eat grass when they are ill and feel better after regurgitation, which gave her the idea of the wheatgrass detox. Because we have fewer stomachs than cows do, she hatched the idea of blending freshly cut wheatgrass into juice form for easier digestion — through either orifice — a practice still employed today. She believed that the enzymes and chlorophyll in wheatgrass constitute its healing powers.

According to William T. Jarvis, a retired professor of public health at the Loma Linda University School of Medicine and founder of the National Council against Health Fraud, this is all baloney: “Enzymes are complex protein molecules produced by living organisms exclusively for their own use in promoting chemical reactions. Orally ingested enzymes are digested in the stomach and have no enzymatic activity in the eater.” Jarvis adds, “The fact that grass-eating animals are not spared from cancer, despite their large intake of fresh chlorophyll, seems to have been lost on Wigmore. In fact, chlorophyll cannot ‘detoxify the body’ because it is not absorbed.”

I tried wheatgrass juice at the Oh Happy Days natural food store in Altadena, Calif., as part of an investigation for the pilot episode of Skeptologists, a series we hope to sell to a television network (where another biblical phrase is apropos: “Many are called, but few are chosen”). My co-stars — Kirsten Sanford, who has a Ph.D. in physiology and is now a science journalist, and Steven Novella, director of general neurology at the Yale School of Medicine — also imbibed. If a picture is worth a thousand words, I will double this essay’s length by sharing the snapshot above.

The latest fad in cold remedies is full of hot air

I violated Feynman’s first principle during a recent book tour. I traveled daily through congested airports, crowded jets and crammed bookstores amid sneezing, coughing, germ-infested multitudes. One day, while squeezed into the sardine section of coach, with the guy behind me obeying the command of the germs in his lungs to go forth and multiply, I cursed myself for having forgotten my Airborne tablets, an orange-flavored effervescent concoction of herbs, antioxidants, electrolytes and amino acids that fizzles into action in a glass of water.

In the logic-tight compartments of my brain, my magic module had trumped my skeptic module. I had not given this product any thought until, much to my chagrin, the host for one of my book tour stops, a Menlo Park, Calif., Internet venture capitalist and science blogger named David Cowan,
mentioned that recently he had debunked Airborne in on his blog. A science-savvy investor, Cowan was quick to spot the clever marketing technique of suggesting that Airborne prevents or cures colds without actually saying so. “Take at the FIRST sign of a cold symptom or before entering crowded environments,” the instructions say. Then “repeat every three hours as necessary.” In the (really) fine print, however, is this: “These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.”

Even more perfidious is how the company turned a liability into an asset. Most drugs are developed by Big Pharma — Brobdingnagian corporations with vast teams of scientists who have, to date, failed to cure the common cold. Airborne’s creator is “Knight-McDowell Labs” — Victoria Knight-McDowell is a schoolteacher and her husband, Rider McDowell, is a scriptwriter. Instead of hiding their lack of credentials, they boast about them on their Web page (www.airbornehealth. com): CREATED BY A SECOND-GRADE SCHOOL TEACHER! “As any confidence artist knows,” Cowan explains in his blog, “disclosing unflattering facts up front wins the target’s trust.” And $100 million in annual sales is all the data the lab needs.

As for real scientific evidence on Airborne, the Web page used to provide a link to “clinical results” (no longer there). When Cowan wrote to the company for the information, h received this reply: “The 2003 trial was a small study conducted for what was then a small company. While it yielded very strong results, we feel that the methodology (protocol) employed is not consistent with our current product usage recommendations. Therefore, we no longer make it available to the public.” Why? The company CEO, Elise Donahue, told ABC News: “We found that it confused consumers. Consumers are really not scientifically minded enough to be able to understand a clinical study.”

ABC News looked into the clinical trial and discovered that it was conducted by GNG Pharmaceutical Services, “a two-man operation started up just to do the Airborne study. There was no clinic, no scientists and no doctors. The man who ran things said he had lots of clinical trial experience. He added that he had a degree from Indiana University, but the school says he never graduated.”

In one final lunge at product verisimilitude (dang it, that zesty taste feels like it works), I consulted Harriet Hall, a retired U.S. Air Force flight surgeon and family physician who studies alternative medicine. Hall looked up Airborne’s ingredients in the Natural Medicines Comprehensive Database and found no evidence that any of the ingredients prevents colds. Worse, vitamin A is unsafe in doses greater than 10,000 units a day, and Airborne contains 5,000 units per tablet and recommends five pills a day or more. The only positive finding was for vitamin C, for which some evidence indicates that taking high doses may shorten the duration of cold symptoms by one to one and a half days in some patients. But the large amounts needed may cause side effects. “There’s more evidence for chicken soup than for Airborne,” Hall told me. “In the absence of any credible double-blind studies to support the claims for Airborne, I’ll stick to hand washing.”

Chicken soup for the traveler’s soul.

Up to 139 times in one week, Kevin Trudeau pitches late-night viewers about his self-published book, Natural Cures “They” Don’t Want You to Know About, a rambling farrago of uninformed opinions, conspiracy theories, and cheeky jabs at medical, pharmaceutical and governmental authorities (“they”). The book is so risibly ridiculous that even the most desperately ill would not take it seriously — would they?

Apparently they would, to the tune of millions of copies sold, elevating the book to the New York Times best-seller list. If readers had purchased Trudeau’s Mega Memory System, perhaps they would have remembered that he spent two years in federal prison after pleading guilty to credit-card fraud and that the Federal Trade Commission banned Trudeau “from appearing in, producing, or disseminating future infomercials that advertise any type of product, service, or program to the public, except for truthful infomercials for informational publications. In addition, Trudeau cannot make disease or health benefits claims for any type of product, service, or program in any advertising, including print, radio, Internet, television, and direct mail solicitations, regardless of the format and duration.” Trudeau had to pay $500,000 in consumer redress for his bogus infomercials and another $2 million to settle charges against him for claiming that coral calcium cures cancer (it doesn’t) and that an analgesic product called Biotape permanently relieves pain (it doesn’t).

Amazingly, Natural Cures is exempt from this injunction. “Books are fully protected speech. He can author a book and voice his opinions,” says Heather Hippsley, assistant director for the division of advertising practices at the FTC who investigated Trudeau’s infomercials, “The line is: Informational materials, OK. Products and services, banned.”

So Trudeau is free to dole out in print such opinions as these: “Medical science has absolutely, 100 percent, failed in the curing and prevention of illness, sickness, and disease.” (Smallpox is not a disease?) “Get all metal out of your dental work.” (Won’t this help the medical cartel?) “Sun block has been shown to cause cancer.” (References?) “Don’t drink tap water.” (Wrong: studies show it is as safe as bottled water.) “Animals in the wild never get sick.” (No need to worry about avian influenza.) “Get 15 colonics in 30 days.” (Can I bring a friend?) “Wear white. The closer you get to white, the more positive energy you bring into your energetic field.” (Why is Trudeau wearing all black on the book cover?) “Stop taking nonprescription and prescription drugs.” (Including insulin for diabetes?) “This includes vaccines.” (Welcome back, polio.) “Have sex.” (Without prescription Viagra?)

This 600-page medical advice book contains no index, no bibliography and no references. In their stead are testimonials for the audio edition and a sequel in the works about “weight loss secrets ‘they’ don’t want you to know about.” As for the “natural cures” themselves, some are not cures at all but just obvious healthy lifestyle suggestions: eat less, exercise more, reduce stress. Some of the natural cures are flat-out wrong, such as oral chelation for heart disease, whereas others are laughably ludicrous, such as a magnetic mattress pad and crocodile protein peptide for fibromyalgia. Worst of all are the natural cures that the book directs the reader to Trudeau’s Web page to find. When you go there, however, and click on a disease to get the cure, you first have to become a Web site member at $499 lifetime or $9.95 a month. It is a classic con man’s combo: bait and switch (the book directs them to the Web page) and double-dipping (sell them the book, then sell them the membership).

Why don’t “they” want you to know about these natural cures? “Money and Power,” Trudeau says. “Most people have no idea just how powerful a motivating force money and power can be.” Kevin Trudeau certainly does, and this book is a testimony to that fact.

There is one lesson that I gleaned from this otherwise feckless author, well expressed in an old Japanese proverb: “Baka ni tsukuru kusuri wa nai desu” — “There is no medicine that cures stupidity.” Domo arigato, Mr. Trudeau.

John Marino was the most driven man I ever met, a monomaniac on a mission to break the U.S. transcontinental cycling record — which he did in 1980, covering the 3,000 miles in 12 days, three hours. I wanted to be like John, so that year I took up serious cycling. In addition to pedaling hundreds of miles a week with him, I followed his training regimen of vegetarian meals, megavitamin dosing, fasting, colonics, mud baths, iridology (iris reading), negative ions, chiropractic, massage and acupuncture.

Although most of the nostrums I tried were useless, I noted with interest (because he beat me) that Jonathan Boyer, the winner of the 1985 Race Across America (co-founded by Marino and me), had a Chinese acupuncturist on his support crew. Given the successes of Marino and Boyer, it seemed possible that there might be a biomedical connection.

Traditional Chinese medicine holds that a life energy called Qi (“chee”) flows through meridians in the body; each of the 12 main meridians represents a major organ system. On these 12 meridians are 365 acupuncture points, one for each day of the year. When yin and yang are out of balance, Qi can become blocked, leading to illness. Inserting needles at blocked points — believed to number about 1,000 — supposedly stimulates healing and health.

This theory lacks any basis in biological reality, because nothing like Qi has ever been found by science. Nevertheless, a medicinal procedure like acupuncture may work for some other reason not related to the original, erroneous theory. Electroacupuncture—the electrical stimulation of tissues through acupuncture needles — increases the effectiveness of analgesic (pain-relieving) acupuncture by as much as 100 percent over traditional acupuncture. So says George A. Ulett, a practicing physician and acupuncturist (with both an M.D. and Ph.D.) and author of the 1992 Beyond Yin and Yang: How Acupuncture Really Works and the 2002 textbook The Biology of Acupuncture (both published by Warren H. Green in St. Louis). Ulett posits that electroacupuncture stimulates the release of such neurochemicals as beta-endorphin, enkephalin and dynorphin, leading to pain relief. In fact, he says, the needles are not even needed — electrically stimulating the skin (transcutaneous nerve stimulation) is sufficient. Ulett cites research in which, using this technique, the amount of gas anesthetic in surgery was reduced by 50 percent.

These findings might help explain the results of a study published in the May 4, 2005, issue of the Journal of the American Medical Association, in which Klaus Linde and his colleagues at the University of Technology in Munich compared the experiences of 302 people suffering from migraines who received either acupuncture, sham acupuncture (needles inserted at nonacupuncture points) or no acupuncture. During the study, the patients kept headache diaries. Subjects were “blind” to which experimental group they were in; the evaluators also did not know whose diary they were reading. Professional acupuncturists administered the treatments. The results were dramatic: “The proportion of responders (reduction in headache days by at least 50%) was 51% in the acupuncture group, 53% in the sham acupuncture group, and 15% in the waiting list group.” The authors concluded that this effect “may be due to nonspecific physiological effects of needling, to a powerful placebo effect, or to a combination of both.”

In my experience, “needling” (where the acupuncturist taps and twists the flesh-embedded needle) isn’t painful, but it is most definitely noticeable. If acupuncture has effects beyond placebo, it is through the physical stimulation and release of the body’s natural painkillers. Finding that sham acupuncture is as effective as “real” acupuncture demonstrates that the Qi theory is full of holes. The effects of being poked by needles, however, cannot be ignored. Understanding the psychology and neurophysiology of acupuncture and pain will lead to a better theory. And for all such alternative medicine claims, testimonials can steer us in the direction of where to conduct research; science is the only tool that can tell us whether they really work or not.

As a skeptic, I am often asked my position on immortality. “I’m for it, of course,” is my wiseacre reply.

Unfortunately, every one of the 100 billion humans who have ever lived has died, so the outlook does not bode well. Unless you follow the trend line generated by Ray Kurzweil and Terry Grossman in Fantastic Voyage: Live Long Enough to Live Forever (Rodale, 2004): “The rate of technical progress is doubling every decade, and the capability (price performance, capacity, and speed) of specific information technologies is doubling every year. Because of this exponential growth, the 21st century will equal 20,000 years of progress at today’s rate of progress.” Within a quarter of a century, the authors say, “nonbiological intelligence will match the range and subtlety of human intelligence,” then “soar past it because of the continuing acceleration of information-based technologies, as well as the ability of machines to instantly share their knowledge.” Biotechnologies, such as designer drugs and genetic engineering, will halt the aging process; nanotechnologies, such as nanorobots, will repair and replace cells, tissues and organs (including brains), reversing the aging process and allowing us to live forever.

To make it to this secular Second Coming (2030 by their calculation), you need “Ray and Terry’s Longevity Program,” which includes 250 supplements a day and weekly rounds of intravenous “nutritionals.” To boost antioxidant levels, for example, Kurzweil suggests a concoction of “alpha lipoic acid, coenzyme Q10, grape-seed extract, resveratrol, bilberry extract, lycopene, silymarin, conjugated linoleic acid, lecithin, evening primrose oil (omega-6 essential fatty acids), n-acetyl-cysteine, ginger, garlic, 1-carnitine, pyridoxal-5-phosphate, and echinacea.” Bon appétit.

Kurzweil is a brilliant and creative mind—the inventor of the first optical character-recognition program and CCD flatbed scanner, creator of the first reading machine for the blind with a text-to-speech synthesizer, recipient of the 1999 National Medal of Technology, and inductee into the National Inventors Hall of Fame. His books The Age of Intelligent Machine and The Age of Spiritual Machines significantly influenced the field of artificial intelligence. Thus, when Ray Kurzweil speaks, people listen. But my baloney-detection alarm went off in three areas of his work.

One, I am skeptical of the effectiveness of nutritional supplements. When I was bike racing in the 1980s, I went through a period of megadosing vitamins and minerals that produced brightly colored urine but no noticeable performance difference. The testimonials behind such nutritional claims are powerful, but the science is weak. The fact that the field is fraught with fads and ever changing claims for “X” as the elixir of health and longevity does not bode well. Nutritional science says that we get virtually all the vitamins and minerals we need through a balanced diet and that more is not better (see www.nutriwatch.org). These diets help us live longer lives, but no one can exceed the maximum human life span of 120 years. The 56-year-old Kurzweil declares that his program has reduced his biological age to about 40. I’m no aging expert or carny barker, but if I had to guess his age from his author photo I’d say, uh, 56.

Two, I question the idea of extrapolating trend lines very far into the future. Human history is highly nonlinear and unpredictable. Plus, in my opinion, the problems of creating artificial intelligence and halting aging are orders of magnitude harder than anyone has anticipated. Machine intelligence of a human nature could be a century away, and immortality is at least a millennium away, if not unattainable altogether.

Three, I am doubtful whenever people argue that the Big Thing is going to happen in their lifetime. Evangelicals never claim that the Second Coming is going to happen in the next generation (or that they will be “left behind” while others are saved). Likewise, secular doomsayers typically predict the demise of civilization within their allotted time (but that they will be part of the small surviving enclave). Prognosticators of both religious and secular utopias always include themselves as members of the chosen few. Hope springs eternal.

Henry Louis Mencken was a stogie-chomping, QWERTY-pounding social commentator in the first half of the 20th century who never met a man or a claim he didn’t like … to disparage, critique or parody with wit that would shame Dennis Miller back to Monday Night Football. Stupidity and quackery were favorite targets for Mencken’s barbs. “Nature abhors a moron,” he once quipped. “No one in this world, so far as I know … has ever lost money by underestimating the intelligence of the great masses of the plain people,” he famously noted. Some claims are so preposterous, in fact, that there is only one rejoinder: “One horselaugh is worth ten thousand syllogisms.” I call this “Mencken’s maxim,” and I find that it is an appropriate response to preposterous claims made about magic water sold on the Web. I offer as a holotype of Mencken’s maxim the following: Golden ‘C’ Lithium Structured Water.

This “is pure water infused with the energies of the Golden ‘C’ crystal, a very special and extremely rare stone mined near San Diego at the turn of the 20th century.” The stone “contains more lithium than any other stone on the planet” and “emits a signature one-of-a-kind healing energy.” How does the Golden ‘C’ water get these magical qualities? Crystal and water are placed in a ceramic container in a “dark and quiet space” for 24 hours, then the water is poured into “violet glass bottles” that “energize it.” Finally, “each violet bottle is placed precisely within a special copper pyramid, specially designed to have the exact Sacred Geometry to create a Pillar of Light Jacob’s Ladder vortex.”

At only $15 per half-ounce, Golden ‘C’ water is a bargain because it “aligns and balances chakras and meridians; acts as a negative ion generator; clears stressful emotions and negative thought forms; clears all negative energy from crystals, food, rooms, people and pets; eases stress; disperses anger; improves immune system; clears bed of nightmare energy and previous energy of dreams; improves mental concentration; facilitates deeper meditations; hydrates and soothes skin; creates environment for visionary dreams.” And, most important, it “clears and protects from electromagnetic pollution such as kitchen appliances, TV, microwave emissions from ovens and the environment, electrical clocks, stereos, high electrical wire lines, etc.” As evidence we are offered this factoid: “Using an instrument to measure wavelengths of light, Holy Water from Lourdes, France, registered 156,000 angstroms of light. Golden ‘C’ water registered 250,000 angstroms of light!”

Wait! That’s not the best Mencken moment to come. Just below the order button a warning label reads: “Note: no actual lithium is in the water. Only the energetics of lithium and the other minerals is contained in the water.” Maybe that explains another disclaimer, perhaps written with attorneys in mind: “No therapeutic, drug or healing claims related to the physical body are made in the use of Golden ‘C’ Lithium Structured Water.” One is advised, however, to keep it refrigerated.

In case any credulity remains, according to Ray Beiersdorfer, professor of geochemistry at Youngstown State University, “exposing ordinary water to lithium crystals, or any other crystals for that matter, cannot fundamentally alter the molecular structure of the water. The chemical structure within the water molecule, as defined by bond length and orientation, doesn’t change. The claim that the chemical structure of liquid water changes because of exposure to a relatively insoluble crystal is nonsense.”

For another Mencken moment, check out tachyonized superconductor water at www.tachyon-energy-products.com. Its promoter, Gene Latimer, explains its benefits: “I am now living in a radically different electromagnetic field environment that appears to be harmonizing the chaotic impact of electrical Alternating Current on the life forms in our house.” All the lifeforms? Wow! And guess what? Tachyon is not limited to water. You can order tachyonized gel, algae, spirulina, herbs, mattress pads, massage oil and even “star dust.” Sprinkle lightly.

We would all do well to follow another Mencken observation: “I believe it is better to tell the truth than to lie … And I believe that it is better to know than to be ignorant.” Amen to that, brother.

After being poked, scanned, drugged and radiated, your doc tells you nothing more can be done to cure what ails you. Why not try an alternative healing modality? What’s the harm?

I started thinking about this question in 1991, when my normally intelligent mother presented to a psychiatrist symptoms of cognitive confusion, emotional instability and memory loss. Within an hour it was determined that she was depressed. I didn’t buy it. My mom was acting strangely, not depressed. I requested a second opinion from a neurologist.

A CT scan revealed an orange-size meningioma tumor. After its removal, my mom was back to her bright and cheery self — such a remarkably recuperative and pliable organ is the brain. Unfortunately, within a year my mom had two new tumors in her brain. Three more rounds of this cycle of surgical removal and tumor return, plus two doses of gamma knife radiation (pinpoint-accurate beams that destroy cancer cells), finally led to the dreaded prognosis: there was nothing more to be done.

What is a skeptic to do? An ideological commitment to science is one thing, but this was my mom! I turned to the literature, and with the help of our brilliant and humane oncologist, Avrum Bluming, determined that my mom should try an experimental treatment, mifepristone, a synthetic antiprogestin better known as RU-486, the “morning after” contraception drug. A smallsample study suggested that it might retard the growth of tumors. It didn’t work for my mom. She was dying. There was nothing to lose in trying alternative cancer treatments, right? Wrong.

The choice is not between scientific medicine that doesn’t work and alternative medicine that might work. Instead there is only scientific medicine that has been tested and everything else (“alternative” or “complementary” medicine) that has not been tested. A few reliable authorities test and review the evidence for some of the claims — notably Stephen Barrett’s Quackwatch, William Jarvis’s National Council Against Health Fraud, and Wallace Sampson’s journal The Scientific Review of Alternative Medicine.

Most alternatives, however, slip under the scientific peer review radar. This is why it is alarming that, according to the American Medical Association, the number of visits to alternative practitioners exceeds visits to traditional medical doctors; the amount of money spent on herbal medicines and nutrition therapy accounts for more than half of all out-of-pocket expenses to physicians; and, most disturbingly, 60 percent of patients who undergo alternative treatments do not report that information to their physician — a serious, and even potentially fatal, problem if herbs and medicines are inappropriately mixed.

For example, the September 17 issue of the Journal of the American Medical Association reported the results of a study on St. John’s wort. The herb, derived from a blooming Hypericum perforatum plant and hugely popular as an alternative elixir (to the tune of millions of dollars annually), can significantly impair the effectiveness of dozens of medications, including those used to treat high blood pressure, cardiac arrhythmias, high cholesterol, cancer, pain and depression. The study’s authors show that St. John’s wort affects the liver enzyme cytochrome P450 3A4, essential to metabolizing at least half of all prescription drugs, thereby speeding up the breakdown process and shortchanging patients of their lifesaving medications.

But there is a deeper problem with the use of alternatives whose benefits have not been proved. All of us are limited to a few score years in which to enjoy meaningful life and love. Time is precious and fleeting. Given the choice of spending the next couple months schlepping my mother around the country on a wild goose chase versus spending the time together, my dad and I decided on the latter. She died a few months later, on September 2, 2000, three years ago to the day I penned this column.

Medicine is miraculous, but in the end, life ultimately turns on the love of the people who matter most. It is for those relationships, especially, that we should apply the ancient medical principle Primum non nocere — first, do no harm.

As a long-time public defender of modern scientific medicine, I have commonly labeled medical scientists as wise of mind, and alternative medical practitioners as fools. The wind of quackery we have inherited, I reasoned, is surely the result of an uneducated public duped by the otherwise risible tactics of flimflam artists praying on the unsuspecting masses. I am no longer sure that this is the source of the headlong rush toward these New Age medical alternatives. “The fault,” Shakespeare correctly identified in another context, “is not in our stars, but in ourselves.”

Indeed, the data contradicts my “fools” hypothesis: studies published in the New England Journal of Medicine and the Journal of the American Medical Association reveal that the typical complementary and alternative medicine (CAM) patient is white, college-educated, with an annual income exceeding $50,000. Despite the miracles that traditional allopathic medicine (TAM) has produced — the cumulative results of which have led to a doubling of the average lifespan from just a century ago — by the late 1990s the number of visits to CAM providers exceeded the number of visits to TAM providers. By the end of the decade total payments to CAMers averaged a staggering $27 billion per year, 58% of which was out-of-pocket payments. CAM sells.

In rejecting the “fools” hypothesis we must consider the possibility that people are going alternative because their needs are not being met by traditional medicine. Before the 20th century this certainly was the case. Medical historians, in fact, are in agreement that until well into the 20th century it was safer not to go to a doctor, thus leading to the success of such nonsense as homeopathy — a totally worthless nostrum that also did no harm, thus allowing the body to heal itself. Since humans are pattern-seeking animals we credit as the vector of healing whatever it was we did just before getting well. This is also known as magical thinking.

What are CAMers offering that TAMers are not? The answer is that all-important component so highly developed in pre-20th century medicine: TLC. By this I do not just mean a hand squeeze or a hug, but an open and honest relationship with patients and their families that provides a realistic assessment of the medical condition and prospects. People are going alternative because physicans have become highly skilled technicians — cogs in the cold machinery and massive bureaucracy of modern medicine.

The shift in my thinking about this problem developed over the past eight years as I became intimately involved in my mother’s recurring and malignant meningioma brain tumors. She finally succumbed, but in the process I gained a deeper understanding of why people turn to alternative medicine. Don’t get me wrong — my mother’s doctors were brilliant, her care the very best available, and we have no regrets about what might have been. And that’s the point. Even under such ideal conditions I found the whole experience frustrating and unfullfilling: it was nearly impossible to get honest and accurate information about my mom’s condition; neither my father nor I could get doctors to return our calls; misinformation and (usually) no information was the norm; and despite my best efforts, the relationship with her physicians (with one exception — her oncologist whom I befriended), could not have been more detached.

I found it rather telling, for example, that when I identified myself as “Dr. Shermer” I got faster results at the hospital than when I was merely “Mr. Shermer” (a lie of omission, not commission, since I do have a Ph.D.), but I still could not get calls returned. Even worse, when my mom’s oncologist (one of the country’s best-known and well-respected in his field) called her surgeons, he too could not get a return call. If physicians show such a remarkable lack of professional courtesy with their own colleagues, what are the rest of us to expect?

More than anything patients want information. They want to know what is really going on. They don’t want jargon. They don’t want false hope or unnecessary pessimism. Studies show that patients do better when they know in detail all the steps they will have to take in their recovery process — probably because it allows them to anticipate, plan, and pace themselves. Knowledge is power, and physicians are the modern-day shamans. Patients want the power that knowledge brings, and that empowerment cannot be given in the 8.5 minutes the average doctor spends with a patient on any given visit. Patients want a relationship with their primary caretaker that allows them to ask the important questions and expect honest answers.

Since I have a doctorate in the history of science, professional training in statistics and research methodologies, and some internet skills, I was able to answer a lot of questions on my own by doing research. But how many people are so equipped to conduct their own medical investigations? And isn’t this what physicians are trained to do?

Yes, of course; but, tragically, they are not trained to communicate that research. And herein lies the problem…and the solution. Physicians tend to have monologues when they should be having dialogues. The reasoning process of diagnosis, prognosis, and treatment all goes on inside their heads, and what comes out is a glossed telegram of truncated lingo. The physician-patient connection is a one-way street, an authority-flunky relationship top heavy in arrogance and off-putting to anyone with a modicum of self-esteem and social awareness. If I could reduce all this into a single request, it is this: Talk to patients as if they are thoughtful, intelligent people capable of understanding and deeply curious about their condition.

The real tragedy in this health care crisis is that CAMers lack much medical knowledge and (especially) scientific reasoning, making them dangerous. Studies show that 40% of patients going to CAMers do not tell their primary care physicians, thus leading to possibly deadly mixtures of drugs and herbs. It is not a matter of everything to gain and nothing to lose by going alternative (even if your doc offers no hope), because quack medicines cost money, cause harm, and, most importantly, take away valuable time that could and should be spent with loved ones in this already too-short of a stay we have with each other.

Physicians are wise of mind. They must also become wise of heart so as not to inherit the alternative wind, for as Solomon continues in the next passage: “The fruit of the righteous is a tree of life; and he that winneth souls is wise.”

This opinion editorial was originally published in Toronto Globe & Mail.