the official site of Michael Shermer

Estimating the number of people who have
experienced the paranormal or supernatural

The Drake Equation is the famous formula developed by the astronomer Frank Drake for estimating the number of extraterrestrial civilizations:

N = R × f_p × n_e × f_l × f_i × f_c × L where…

• N = the number of communicative civilizations,
• R = the rate of formation of suitable stars,
• f_p = the fraction of those stars with planets,
• n_e = the number of earth-like planets per solar system,
• f_l = the fraction of planets with life,
• f_i = the fraction of planets with intelligent life,
• f_c = the fraction of planets with communicating technology, and
• L = the lifetime of communicating civilizations.

The equation is so ubiquitous that it has even been employed in the popular television series The Big Bang Theory for computing the number of available sex partners within a 40-mile radius of Los Angeles (5,812). My favorite parody of it is by the cartoonist Randall Munroe as one in a series of his clever science send-ups, entitled “The Flake Equation” (on xkcd.com) for calculating the number of people who will mistakenly think they had an ET encounter.

Such multiplicative equations for calculating the product of an increasingly restrictive series of fractional values are effective tools for making back-of-the-envelope calculations to solve problems for which we do not have precise data. To that end I thought it a useful addition to the Skeptic toolbox to create a Flake Equation for all paranormal and supernatural experiences (and in the Flake Equation I’m interested not in beliefs but in actual experiences that people report and that we hear about, because this becomes the foundation of paranormal and supernatural beliefs):

N = P_w × f_p × f_m × f_t × n_t × n_o × f_m where…

• N = Number of people we hear about who report having experienced a paranormal or supernatural phenomena,
• P_w = Population of the United States (January 1, 2012: 312,938,813),
• f_p = Fraction of people who report having had an anomalous psychological experience or witnessed an unusual physical phenomena (1/5),
• f_m = Fraction of people who interpret such experiences and phenomena as paranormal or supernatural (1/5),
• f_t = Fraction of people who tell someone about their experience (1/10),
• n_t = Number of people they tell (15),
• n_o = Number of other people told the story by original hearers (15), and
• f_m = Fraction of such stories reported in the media or on Internet blogs, tweets, and forums (1/10).

N = 28,164,493, or about 9 percent of the U.S. population.

To compute this figure I used the 2005/2007 Baylor Religion Survey, which reports that

• 23.2% say that they have “witnessed a miraculous, physical healing,”
• 16.3% “received a miraculous, physical healing,”
• 27.5% “witnessed people speaking in tongues at a place of worship,”
• 7.7% “spoke or prayed in tongues,”
• 54.5% experienced being “protected from harm by a guardian angel,”
• 5.9% “personally had a vision of a religious figure while awake,”
• 19.1% “heard the voice of God speaking to me,”
• 26.1% “had a dream of religious significance,”
• 52% “had an experience where you felt that you were filled with the spirit,”
• 22.1% “felt at one with the universe,”
• 25.7% “had a religious conversion experience,”
• 13.8% “had an experience where you felt that you were in a state of religious ecstasy,”
• 14.2% “had an experience where you felt that you left your body for a period of time,”
• 40.4% “had a dream that later came true,” and
• 16.7% “witnessed an object in the sky that you could not identify (UFO).”

This works out to an average of 24.4 percent, thereby justifying my conservative 20 percent figure for f_p and f_m. The other numbers I gleaned from research on gossip and social networks, conservatively estimating that 10 percent of people will tell someone about their unusual experience, and that within their average social network of 150 people they will tell at least 10 percent of them (15) who in turn will pass on the story to 10 percent of their social network of 150 (15). Finally, I estimate that 10 percent of such stories will be reported in the media or recounted in blogs, tweets, forums, and the like.

Of course the final figure for N will vary considerably depending on what numbers are plugged into the equation, but the result will almost always be a number in the tens of millions, which goes a long way toward explaining why belief in the paranormal and supernatural is so ubiquitous. Experiencing is believing!

This is a review of The Better Angels of Our Nature: Why Violence Has Declined, by Steven Pinker
(October 2011, Viking. 771 pages. ISBN 978-0-670-02295-3). Originally published in the Autumn issue of The American Scholar as “Getting Better All the Time.”

In The Man Who Shot Liberty Valance, John Ford’s classic 1962 film, a clash of moral codes unfolds in the wild-west frontier town of Shinbone, Arizona. I call these moral codes the Cowboy Code, where disputes are settled and justice is served between individuals who have taken the law into their own hands, and the Law Code, where disputes are settled and justice is served between all members of the society who, by virtue of living there, have tacitly agreed to obey the rules. The Cowboy Code is represented by John Wayne’s character, Tom Doniphon, a fiercely loyal and deeply honest gunslinger duty-bound to enforce justice on his own terms through the power of his presence backed by the gun on his hip. The Law Code is embodied by Jimmy Stewart’s Ransom Stoddard, an attorney hell bent on seeing his beloved Shinbone make the transition from cowboy justice to the rule of law. Lee Marvin’s Liberty Valance is a coarse highwayman who respects only one man, Tom Doniphon, because they share the Cowboy Code that men settle their disputes between themselves. Despite Valance’s constant taunting of the law, Stoddard holds to his belief that until Valance is caught doing something illegal there can be no justice. When Doniphon tells Stoddard “You better start pack’n a handgun,” Stoddard rejoins, “I don’t want to kill him. I just want to put him in jail.” At long last, however, Stoddard decides to take Doniphon’s advice that “out here a man settles his own problems,” and turns to him for gun-fighting lessons. When Valance challenges Stoddard to a dual, the overconfident naïf accepts and a late-night showdown ensues. In a darkened street, the two men square off. Stoddard is trembling in fear while Valance mocks and scorns him, shooting first too high and then too low. When Valance takes aim to kill, Stoddard shakily draws his weapon and discharges it. Valance collapses in a heap. Having felled one of the toughest guns in the west Stoddard goes on to become a local hero, building that image into political capital and working his way up from local politics to a distinguished career as a United States Senator.

So it would appear that the Law Code prevailed over the Cowboy Code, but not so fast. In the end we learn that the man who shot Liberty Valance was Tom Doniphon. Knowing that Stoddard was no match for Valance, in a flashback replay of the dual from another perspective we see Doniphon lurking in the shadows and fingering a rifle, which he engaged to kill Valance at the crucially-timed moment when the two men drew their weapons. Holding to the Cowboy Code of loyalty, Doniphon takes the secret to his grave.

The fictional Shinbone embodies any small community in transition from an informal to a formal moral code and system of justice. When everyone takes the law into their own hands there is no law, and thus the opportunities for unchecked violations of informal codes expands exponentially as populations increase, leading to an increase in violence and requiring the creation of such social technologies as codes, courts, and constitutions. The transition from the informal rule of frontier justice found in pre-modern societies to the formal rule of law pervasive throughout modern democratic nations is a result of the creation of a myriad of political and economic systems and legal and moral codes that together have led to a systematic decline of violence in what the Harvard psychologist Steven Pinker calls “the civilizing process” in his book The Better Angels of Our Nature. The title comes from Abraham Lincoln’s Inaugural Address on March 4, 1861, as America was about to fall into anything but a civilizing process of civil war (so his memorable words are more prescriptive than descriptive):

The mystic chords of memory, stretching from every battlefield and patriot grave to every living heart and hearthstone all over this broad land, will yet swell the chorus of the Union, when again touched, as surely they will be, by the better angels of our nature.

Four years and 600,000 dead later, our better angels finally emerged. Or did they? What about the First and Second World Wars, not to mention the Holocaust, Stalin’s purges, Mao’s cultural revolution, Cambodia’s killing fields, and the numerous genocides in Africa? With bodies stacked like cordwood and the ashes in the crematoria still cooling in living memory, how can anyone seriously argue that there has been a decline in violence? Because, Pinker demonstrates through compelling anecdotes and copious charts, long-term data trumps recent anecdotes. The idea that we live in an exceptionally violent time is an illusion created by the media’s relentless coverage of violence, coupled to our brain’s evolved propensity to notice and remember recent and emotionally salient events, of which violence plays second fiddle to no one. Unfortunately, our brains did not evolve to carefully track long-term trends, and thus it is that evolution, along with climate change and other historical sciences, seems counterintuitive. And Pinker’s thesis is nothing if not counterintuitive: that violence of all kinds—from murder, rape, and genocide to parents spanking their kids to the treatment of blacks, women, gays, and animals—has been in decline for centuries as a result of this civilizing process.

Picking up Pinker’s 771-page magnum feels daunting, but it’s a page-turner from the start as he reminds us through literary anecdotes of what life was like in the foreign country known as the past. To wit, Homer’s Agamemnon explains to King Menelaus his war strategy: “We are not going to leave a single one of them alive, down to the babies in their mothers’ wombs—not even they must live. The whole people must be wiped out of existence, and none be left to think of them and shed a tear.” The Bible (the “Good Book”), Pinker reminds us, “depicts a world that, seen through modern eyes, is staggering in its savagery. People enslave, rape, and murder members of their immediate families. Warlords slaughter civilians indiscriminately, including the children. Women are bought, sold, and plundered like sex toys. And Yahweh tortures and massacres people by the hundreds of thousands for trivial disobedience or for no reason at all.” In fact, the book opens with a murder. After creating the heavens and the earth and Adam and Eve and their two boys Cain and Able, the former killed the latter. “With a world population of exactly four,” Pinker notes, “that works out to a homicide rate of 25 percent, which is about a thousand times higher than the equivalent rates in Western countries today.”

Pinker is not being flippant. A graph in the next chapter, for example, presents the data from dozens of studies revealing the percentage of deaths in warfare from prehistoric times to present. The contrast is striking: Prehistoric peoples and modern hunter-gatherers and hunter-horticulturalists are far more murderous than states, with percentages for the former ranging from 10 to 60 percent and an average of 24.5 percent compared to 5 percent and under for the latter. Even the bloody 20th century wars weren’t so bloody by comparison: About 40 million people died in battle deaths during the century in which around six billion people lived, which amounts to 0.7 percent battle deaths. What about noncombat deaths, such as all those citizens who became the collateral damage of war? “Even if we tripled or quadrupled the estimate to include indirect deaths from war-causes famine and disease, it would barely narrow the gap between state and nonstate societies,” Pinker retorts. What about all those genocides and the Holocaust? That brings the death toll up to 180 million deaths, which “still amounts to only 3 percent of the deaths in the 20th century.” What about the 21st century? In 2005, Pinker computes, a grand total of 0.008, or eight tenths of one percent of Americans died in two foreign wars and domestic homicides combined. In the world as a whole, the rate of violence from war, terrorism, genocide, and killings by warlords and militias was 0.0003 of the total population, or three hundredths of one percent.

The numbers go on and on like this for hundreds of pages, punctuated by poignant anecdotes that drive home the point that things really are getting better and that these are the good old days. Readers of this book, Pinker reminds us, “no longer have to worry about abduction into sexual slavery, divinely commanded genocide, lethal circuses and tournaments; punishments on the cross, rack, wheel, stake, or strappado for holding unpopular beliefs, decapitation for not bearing a son, disembowelment for having dated a royal, pistol duels to defend their honor, beachside fisticuffs to impress their girlfriends, and the prospect of a nuclear world war that would put an end to civilization or to human life itself.” You can, of course, think of a few exceptions here and there, but that’s the point: what used to be commonplace is now rare, and in most of the above examples, nonexistent. Why?

Science is a three-legged stool of data, theory, and communication. Having convinced readers that violence is in decline through data well communicated, Pinker devotes the rest of his tome to his theory that the better angels of our nature are brought out by the civilizing process of two forces: the top-down rule of law and the bottom-up rule of morals. More generous than most scholars in crediting others’ work, Pinker’s grounds his theory in the Jewish historian Norbert Elias’s 1939 book The Civilizing Process, a catalogue of examples from the archives of history demonstrating that over the centuries, “beginning in the 11th or 12th and maturing in the 17th and 18th, Europeans increasingly inhibited their impulses, anticipated the long-term consequences of their actions, and took other people’s thoughts and feelings into consideration. A culture of honor—the readiness to take revenge—gave way to a culture of dignity—the readiness to control one’s emotions. These ideals originated in explicit instructions that cultural arbiters gave to aristocrats and noblemen, allowing them to differentiate themselves from the villains and boors. But they were then absorbed into the socialization of younger and younger children until they became second nature.”

Second nature. Our first nature is to be selfish, greedy, and nasty. Our second nature—the better angels of our nature—requires a little coaxing and persuading to come out. Analysis of medieval books of etiquette, for example, reveal that the numerous prohibitions are reducible to a few principles related to this second nature, as Pinker notes: “Control your appetites; Delay gratification; Consider the sensibilities of others; Don’t act like a peasant; Distance yourself from your animal nature. And the penalty for these infractions was assumed to be internal: a sense of shame.” Externally, other forces were at work along the lines of what I described in the shift from the Cowboy Code to the Law Code. These include, in Pinker’s words, “the centralization of state control and its monopolization of violence, the growth of craft guilds and bureaucracies, the replacement of barter with money, the development of technology, the enhancement of trade, the growing webs of dependency among far-flung individuals,” and the like.

Again—and it must be repeated in every discussion of this controversial topic—the decline of violence is tracked in a systematic sloping downward curve with occasional bumps along the way. Think of a saw blade tilted down at an angle. Individual teeth point upward, but the overall slope of the blade is downward. Or think global warming. Yes, some years are cooler—and climate deniers are only to happy to point them out—but the overall trend is that of a warming earth. The analogy applies to violence of all kind. Compared to 500 or 1000 years ago, today a greater percentage of people in more places more of the time are safer, healthier, wealthier, and freer. With the recent ascendency of the Tea Party movement and the media coverage of angry white men, liberals understandably believe that things are grim and getting worse. But, in fact, Pinker notes that “in every issue touched by the Rights Revolutions—interracial marriage, the empowerment of women, the tolerance of homosexuality, the punishment of children, and the treatment of animals—the attitudes of conservatives have followed the trajectory of liberals, with the result that today’s conservatives are more liberal than yesterday’s liberals.”

This is a shift to be celebrated, even as we honor the principle of that other great American President, Thomas Jefferson, that eternal vigilance is the price of freedom.

In the 2010 documentary film, The Tillman Story, the story of Pat Tillman and his tragic death at the hands of “friendly fire” is retold. Tillman was the NFL star who gave it all up to join the military cause in Afghanistan after being inspired by 9/11 to do something for his country. He did not do it for the glory or publicity, and gave up a lucrative football career for what he perceived to be a worthy cause. After his death the U.S. government implemented a publicity campaign to use Tillman’s death as a tool to promote the war as a cause so worthy that even a highly-paid NFL star believed it to be worth the sacrifice. What the government failed to mention is that Tillman was killed at the hands of his fellow soldiers during a “fog of war” incident in a steep and narrow slot canyon in which there was much confusion about where enemy fire was originating. It’s a very disturbing film to watch—infuriating in fact—and Jon Krakauer’s book, Where Men Win Glory, presents the story in excruciating detail in a compelling narrative.

Pat Tillman was an atheist. At his funeral his younger brother Richard got up to speak, visibly upset, noticeably inebriated, and with beer in hand proceeded to thank everyone for their warm sentiments, but upbraided those like Maria Shriver and Senator John McCain who made religious overtones in their sentiments, noting about his brother Pat: “He’s not with God, he’s fucking dead. He’s not religious. Thanks for your thoughts, but he’s fucking dead.”

Later in the film there is a radio interview presented with Colonel Ralph Kauzlarich, who was the Regimental Executive Officer at Forward Operating Base Salerno on Khost, Afghanistan, under which Tillman was serving at the time of his death, and who led the military investigation into Pat’s death. I found the following exchange to be among the most disturbing things in the entire film that was missed by most reviewers, starting in reference to the grieving Tillman family who were at the time vigorously pursuing an investigation into Pat’s death and the government cover up of it:

Kauzlarich: “These people are having a hard time letting it go. It may be because of their religious beliefs. I don’t know how an atheist thinks, but I can only imagine that that would be pretty tough. If you’re an atheist and you don’t believe in anything, if you die what is there to go to? Nothing. You’re worm dirt. It’s pretty hard to get your head around that.”

Host: “So you suspect that’s probably the reason this thing [the family’s persistence in getting to the bottom of Pat’s death] is running on.”

Kauzlarich: “I think so. There’s not a whole lot of trust in the system or faith in the system.”

So…if you’re an atheist it means that you’re not going to buy into the belief that death—even a tragic, unnecessary, and friendly-fire death—will somehow be made acceptable by the belief that all will be made right in heaven where all the good Conservative Christian soldiers will meet up once again. This is very disturbing. What this knucklehead nincompoop is saying is that if the Tillman family were good Christians they would have gone along with the patriotic platitudes of the military in assuaging everyone’s grief by pretending that it was all done in the name of god and country. But since the Tillmans are atheists it means that they actually want truth and justice now! How inconvenient. How pathetic. And this is yet another point against religious belief: it leads you to blur your focus on the here-and-now and let slip your grip on reality, and allow yourself to be manipulated by those who have neither the conscience nor the courage to stand up for what is right and true.

TO ALL TEACHERS AND PROFESSORS who are teaching courses in skepticism, critical thinking, science and pseudoscience, science and the paranormal, science studies, history or philosophy of science, the psychology of paranormal beliefs, religious studies, and the like…

Please send us your course syllabuses, reading lists, video/YouTube links, classroom demonstration ideas, student projects and experiments, research project ideas, and the like to my graduate student Anondah Saide. I want to add them to my own course syllabus on Skepticism 101, and create an online Skeptical Studies Program at Skeptic.com for teachers and professors everywhere to go to in a creative commons/open source system so that we can build a new academic field going forward with skepticism into academia.

I know that such courses are being taught around the world because for the past two decades of publishing Skeptic magazine and writing skeptical books, I receive a lot of mail from teachers and professors seeking permission to use our materials.

What I would like to do is to create academic departments of Skeptical Studies, as the next step in the skeptical movement. (See, for example, Phil Zuckerman’s program of Secular Studies he is implementing this year at Pitzer College in Claremont, where I teach a graduate course in the spring. We have magazines and journals, trade books and conferences. The next step is a more organized penetration into academia via courses, textbooks, departments, and the like. I want to create a clearing house, an open-source site for people to access materials that will be made available to create your own course in Skeptical Studies, such as Skepticism 101: syllabuses, books, articles, assignments, videos, demonstrations, experiments, research projects, and the like. I am envisioning something along the lines of how psychology became an academic field a century ago.

To start the process off I share with you my own course syllabus for Skepticism 101, which I am teaching this semester starting this week at Chapman University on Tuesdays from 4–7pm with 36 freshman, the future of the skeptical movement!

Download Shermer’s Course Syllabus for Skepticism 101

Email Us Your Ideas

This article first appeared as an alternative medicine opinion editorial for the American Medical Associations’s Virtual Mentor Journal, Volume 13, Number 6: 389–393, June 2011.

For many years now there has been considerable debate between so-called complementary and alternative medicine (CAM) and mainstream science-based medicine. In reality there is no debate because there is only science-based medicine and everything else that has yet to be tested. Most of CAM falls into this latter category. This does not automatically mean that all CAM claims are false; only that most of them have yet to be tested through the rigorous methods of science, which begins with the null hypothesis that holds that the hypothesis under investigation is not true (null) until proven otherwise. A null hypothesis states that X does not cause Y. If you think X does cause Y then the burden of proof is on you to provide convincing experimental data to reject the null hypothesis.

The statistical standards of proof needed to reject the null hypothesis are substantial. Ideally, in a controlled experiment, we would like to be at least 95–99 percent confident that the results were not due to chance before we offer our provisional assent that the effect may be real. Everyone is familiar with the process already through news stories about the FDA approving a new drug after extensive clinical trials. The trials to which they refer involve sophisticated methods to test the claim that Drug X (say a statin drug) improves outcomes in Disease Y (say cholesterol-related atherosclerosis). The null hypothesis states that statins do not lower cholesterol and thus have no effect on atherosclerosis. Rejecting the null hypothesis means that there was a statistically significant difference between the experimental group receiving the statins and the control group that did not.

In most cases CAM hypotheses do not pass these simple criteria. They have either failed to reject the null hypothesis, or they haven’t even been rigorously tested to know whether or not they could reject the null hypothesis.

What, then, is the pull of CAM for so many people? According to a 2002 survey of U.S. adults conducted by the National Center for Health Statistics and the National Center for Complementary and Alternative Medicine: 74.6% had used some form of complementary and alternative medicine, 14.8% “sought care from a licensed or certified” practitioner, suggesting that “most individuals who use CAM self-prescribe and/or self- medicate,”¹ and that the most common CAM therapies used were prayer (45.2%), herbalism (18.9%), breathing methods (11.6%), meditation (7.6%), chiropractic (7.5%), yoga (5.1%), body work (5.0%), diet-based therapy (3.5%), progressive relaxation (3.0%), mega-vitamin therapy (2.8%), and visualization (2.1%).²

A 2004 survey of 1,400 U.S. hospitals found that over 25% offered such alternative and complementary therapies as acupuncture, homeopathy, and massage therapy. According to researchers Sita Ananth of Health Forum, an affiliate of the American Hospital Association, and William Martin, PsyD, of the College of Commerce at DePaul University in Chicago, in a news release: “More and more, patients are requesting care beyond what most consider to be traditional health services. And hospitals are responding to the needs of the communities they serve by offering these therapies.”³

Herein lies one answer to understanding why CAM sells. There is a market demand for it. Why? One possibility is that people are turning to alternative medicine because their needs are not being met by traditional medicine. As the late medical historian Roy Porter was fond of pointing out, before the 20th century this certainly was the case.⁴ 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 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 superstition, or magical thinking.

Another explanation may be found in examining what CAMers are offering that mainstream physicians are not: 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 in too many instances physicians have become highly skilled technicians—cogs in the cold machinery and massive bureaucracy of modern HMO medicine.

I witnessed the effect directly over the course of a decade during 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 unfulfilling: 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 found it difficult to 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 heard too many dial tones. 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 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 per patient per visit. Patients want a relationship with their primary caretaker that allows them to ask the important questions and expect honest answers.

Physicians tend to have monologues when they should be having dialogues. The reasoning process of diagnosis, prognosis, and treatment 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.

So…we should turn to CAM then, right? Wrong. An even deeper problem is that CAMers lack much medical knowledge and (especially) scientific reasoning, making them dangerous. The 2002 study referenced above found that 54.9% used CAM in conjunction with conventional medicine but did not always tell their primary care physician, thus leading to possibly deadly mixtures of drugs and herbs.¹ It is not a matter of everything to gain and nothing to lose by going CAM (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.

Besides TLC, the cognitive pull of CAM is anecdotal thinking. Since humans are pattern-seeking animals, we credit whatever we did just before getting well as the vector of healing. If A appears to be connected to B, we assume that it is unless proven otherwise. This is the very antithesis of the science-based system of the null hypothesis. The recent medical controversy over whether vaccinations cause autism reveals the power of anecdotal thinking. 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 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 it causes 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 rates of autism diagnoses did not decline in children born after thimerosal was removed from vaccines.

The anecdotal thinking upon which CAMers rely—even if unconsciously and with the best of intentions—can be particularly dangerous in the hands of those whose intentions are less than ethical. Thus 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, and the human brain will do the rest. By way of example from the annals of medical quackery, witness the case of John R. Brinkley, one of the greatest medical quacks of the first half of the twentieth century, and his nemesis Morris Fishbein, the quackbusting editor of the Journal of the American Medical Association. Their decades-long struggle that criss-crossed the American heartland throughout the 1920s and 1930s, represents this tension between folk and scientific medicine, well summarized in Pope Brock’s 2008 book Charlatan: America’s Most Dangerous Huckster, the Man Who Pursued Him, and the Age of Flimflam.⁵

What Brinkley was selling was what all men want—sexual vitality—and he developed a surgical technique that offered the type of firm results that his male clientele so desperately sought: goat testis sewn right into the patient’s scrotum, which he likened to “embedding a marble in an apple.” Come one, come all. And they did, to the tune of $750 per surgery, advertised widely in newspapers (an AMA study revealed that over half of all newspaper advertising at the time was for patent medicines) and the new fangled technology—radio—which Brinkley took to like an evangelist to television. The ads featured testimonials from happy men who proclaimed their restored manhood, and these anecdotes made Brinkley a rich man as it drove customers to his practice. But as his business grew he got careless, performing operations both before and after happy hour, and fobbing off work to assistants whose medical credentials were even shadier than his own (Brinkley graduated from the unaccredited and improbably named Eclectic Medical University of Kansas City). The result was dozens of dead patients.⁵

This got the attention of the ambitious Morris Fishbein, whose career coincided with the rise of the AMA’s attempt to rein in flimflammery through accrediting medical colleges and licensing practitioners. Fishbein made his public mark in 1923 when the Chicago Daily News sent him to investigate the “Hot Girl of Escanaba” (Michigan), a woman who suffered from a temperature of 115 degrees for two weeks. Fishbein exposed her as a “hysterical malingerer” when he discovered that a flesh colored hot water bottle was employed to elevate rectal thermometer readings. For the next two decades Fishbein pursued the country’s “most daring and dangerous” swindler, as he called Brinkley, until he finally brought him down in a decisive courtroom confrontation.⁵

Fishbein’s promotion of science-based medicine was heroic in his day, but medical flapdoodle flourishes today on the Internet so every medical association and journal needs a quackbusting Fishbein on its staff, for without such eternal vigilance folk medicine will trump scientific medicine in the minds of patients. And thus it is that skepticism should be our default rule of thumb when it comes to CAM claims.