The Unpersuadables: Adventures with the Enemies of Science (18 page)

Two years later, he was fired
.

The adventure of Dr Jacques Benveniste tells of a crucial principle of sceptical thought: that extraordinary claims require extraordinary evidence. If we are going to allow homeopathy, and therefore overturn much that is widely accepted in science, then we must reasonably expect the conclusions of its study to be exceptional. The tests must be painstakingly designed, and their results consistent, replicable and significant.

So what of the hundred and ten studies that Dr Alexander Tournier presented in his defence? Some of these may well conclude that homeopathy works, but are they any good? This is exactly what
‘Shang et al.’
, the famous paper that Tournier referenced, sought to discover.

When different scientists tackle the same problem and produce conflicting results, one way of making sense of them all is to conduct a meta-analysis. You take the trials, use complex mathematical formulae to blend their data and end up with what you hope is an ultimate conclusion. That is what Professor Aijing Shang’s team, at the University of Berne in Switzerland, sought to do for homeopathy. It was an ambitious project and inevitably controversial. After more than two hundred years of ferocious argument, we would finally know: Does homeopathy work?

To discuss ‘Shang et al.’, I call Dana Ullman, the US homeopath picked out as especially ‘despicable’ by Dr Steven Novella. I begin by asking for his thoughts on the Skeptics.

‘They’re a mixed and motley crew,’ he says. ‘They’re medical fundamentalists and because they follow James Randi, who is a magician, they seek to purposefully misdirect the real issues in healthcare. Some are Big Pharma shills, others are just misinformed. A lot of them are science nerds. I have a science nerd in me, but the difference between me and the average science nerd is that many of them were abused as youngsters. They were hyper-rational and they had inadequate social skills and now they’re on the Internet getting their venom out. They’re bullying back. So my analysis of the reason why some of them are irrationally venomous – and you can use that term: I determine that many of them are
irrationally venomous
– is because they had a difficult childhood where they were abused and now they’re getting back.’

We move on to Shang. His team began by looking for studies of homeopathy that were sophisticated enough to take into account the effects of placebo. Just as Dr Tournier told me, they ended up with a hundred and ten studies that looked at homeopathy’s effect on a wide array of medical conditions.

They wanted to compare these with studies of conventional medicine. So, for each one of their homeopathic studies, they found a matching study from the world of mainstream medication that looked at treatment of the same disorder. So for every test of homeopathy on asthma, for example, they found a test of ordinary medicine on asthma.

First, they analysed the two sets of papers separately. They found that both conventional medicine and homeopathy showed a positive effect above placebo. Simply put, they
both
worked.

Next, they had a look at the quality of each one of those studies. Taking into account variables such as the number of people who took part in each test, they ordered them from the best to the worst and found that the better the study was, the worse the result for homeopathy.

Finally, they isolated the finest homeopathy studies in their pool of a hundred and ten. They found eight that were of the very highest quality. All of them concluded that the evidence for it was ‘weak’ and ‘compatible with the notion that the clinical effects of homoeopathy are placebo effects.’

The result was damning. Homeopathy is nothing more than placebo. The
Lancet
published the study alongside an editorial headlined ‘The End of Homeopathy’.

‘Ha ha ha!’ says Dana.

‘You’re laughing,’ I note.

‘Yes, I laugh at people who are sceptical of homeopathy and use Shang as their firmest body of evidence. People who do that have their feet planted firmly in mid-air. The ground that they’re standing on is Jell-O.’

Dana has several criticisms of Shang. He says that a series of studies that showed strong effects for homeopathy were unfairly ignored. He says that a subsequent critique of the study, published in
the
Journal of Clinical Epidemiology
, accused Shang of ‘post-hoc analysis’ – that is, gathering his evidence first and then using it to find a way to prove homeopathy wrong. He says that some of the papers included were not intended to show whether homeopathy worked. Rather, they were exploratory ‘pilot studies’, carried out to test the design of a proposed experiment for potential problems before it is embarked upon properly. And yet negative results for pilot studies were taken by Shang to be conclusive, and therefore damning of homeopathy in general.

Finally, he disputes the entire basis of what Shang describes as a ‘high quality’ study. In science generally, it is taken to be logically sound that the more people who take part in a test, the more accurate the results will be. However, Dana says that this ignores the basic principles of homeopathy. When you visit a homeopath with stomach pains, say, that homeopath will not only take into account your chief complaint. Rather, he will talk to you for perhaps an hour about a wide range of subjects and take all sorts of apparently unrelated facts into his final decision in what potion or pill to recommend. Therefore, says Dana, the smaller studies are the most accurate, as these were more likely to be the ones in which an individual homeopath took the time to dispense an accurate remedy.

When I recount all this to Andy Lewis of
The Quackometer
, he chuckles knowingly. ‘These are all things Dana has said before, bar the marvellous one where he says small trials are better trials,’ he says. ‘That shows quite a lot of chutzpah. What did you think of that?’

‘To me, it makes sense,’ I admit. ‘Although I do appreciate that it leads us into dangerous territory.’

‘But he’s not telling you the whole truth.’

Andy takes me through Dana’s argument point by point. He says Shang ‘excluded all sorts of trials, and the reasons they were excluded were very specifically set out in the paper. He included a clear methodology because he wanted to make sure that he gave both sides a fair crack of the whip. If Dana could show that he had ignored their criteria, it would be a fatal blow. But no one’s done that.’

Next, Andy tells me that the accusation that Shang was engaged in post-hoc analysis was not, in fact, published in the
Journal of Clinical
Epidemiology
, which is an ‘as good as you can get journal,’ but in a publication that deals exclusively with homeopathy. ‘Oh, what can you say about that?’ he sighs.

Of Dana’s assertion that homeopathy will only work when ‘individualised’ he says, ‘He’s not being complete with the truth.’ In fact, the father of homeopathy, Hahnemann himself, designed a scheme called Genus Epidemicus in which broad symptoms could be treated with the same medication. Indeed, that’s why anyone can walk into Boots without an appointment and buy a homeopathic remedy for a toothache. Also, Andy adds, there are lots of trials for individualised homeopathy. ‘Forty or fifty at least. And the results for these as just as poor as all the others.’

Finally, of Dana’s complaint that trials that were included were only exploratory, Andy says: ‘The vast majority of homeopathy studies would be pilot studies. I don’t think the inclusion criteria took that into account.’

‘So does Dana have a point, then?’

‘Um …’

‘Would you go that far?’

‘Dana is always wrong. So, no. I wouldn’t go that far.’

*

Before his death in 2004, Dr Jacques Benveniste had begun an ambitious project.
‘One day,’ he said, ‘we are going to be able to get our drugs on the phone
. There is no reason why we can’t have this, or have a whole pharmacy on a chip on our credit card.’

His words were prophetic.
Today you can send a strand of your hair
to a homeopath, who will dip it into a solution and beam its health-giving vibrations back to you through the air. You can buy machines that project homeopathic properties into blank pills. It doesn’t require the actual original liquid dilutions – just get someone to email over the correct numeric code for, say,
‘milk of the dolphin’
, ‘dinosaur bone’ or ‘blood of the grizzly bear’ and tap it in. Using this ‘radionic’ method, you don’t even need pills. One proponent travels through Africa, handing MP
₃
files to people with AIDS.

Back in Sutton Coldfield, I wanted to discover a bit more about
Gemma’s practice. Despite the Skeptics’ many campaigns, there are already laws in place that seek to stop homeopaths doing harm.
The Cancer Act 1939
makes it illegal to advertise the ability to cure cancer. This made me curious about Gemma. Although her website makes no mention of the condition, I wanted to know how she dealt with patients while publicly crediting homeopathy with her own recovery. I asked if she had ever treated anyone who was suffering from it.

‘Yes, I have,’ she said. ‘One with brain tumours. He was given two years to live. He came to see me, had some treatment, had a scan and they’d gone.’

‘You realise that claiming the ability to cure cancer is illegal?’

‘I don’t treat the cancer,’ she says. ‘I treat the individual.’

‘You treat the individual with cancer.’

‘I treat people with diseases, but I treat them as an individual.’

‘So if I came to you saying, “I’ve got cancer, I need medicine” you wouldn’t treat that cancer, but the cancer would still disappear?’

She shrugged, ‘Might do.’

‘How do you know that your cancer didn’t just go into remission?’

She looked baffled. Then angry.

‘I was on my deathbed! And it suddenly changed, did it?’

We sat there, for a moment, in the space that now she uses as a consulting room. I took in the books, the pamphlets, the framed certificate in ‘homeopathy and holistic healing’ from ‘The Lakeland College’ and the large chart that explained what to do in various ‘Homeopathy Emergencies’ and I asked one final question.

‘If you died and went to heaven and God sat you down and told you, “Gemma, I have to tell you – homeopathy is nonsense.” Would you believe him?’

She answered in an instant.

‘No.’

It began in the way it often begins, so those that tell of it say: with an explosion of crawling, itching and biting, his skin suddenly alive, roaring, teeming,
inhabited
. A metropolis of activity on his body. This is not what fifty-five-year-old IT executives from Birmingham expect to happen to them on fly-drive breaks to New England. But there it was and there
he
was, in an out-of-town multiscreen cinema in a mall somewhere near Boston, writhing, scratching, rubbing, cursing. His legs, arms, torso – God, it was everywhere. He tried not to disturb his wife and two sons as they gazed up, obliviously, at
Harry Potter and the Order of the Phoenix
. It must be fleas, he decided. Fleas in the seat.

That night, in his hotel, Paul could not sleep. ‘You’re crazy, Dad,’ said the boys. It must be tics, mites, something like that. But none of the creams worked, nor the sprays. Within days, odd marks began to appear, in the areas where his skin was soft. Red ones. Little round things, raised from his skin. Paul ran his fingertips gently over them. There was something growing inside them, like splinters or spines. He could feel their sharp points catching. Back home, he told his doctor, ‘I think it’s something strange.’

Paul had tests. It wasn’t scabies. It wasn’t an allergy or fungus. It wasn’t any of the obvious infestations. Whatever it was, it had a kind of cycle. The creeping and the crawling was the first thing. Then the burrowing and then biting, as if he was being stabbed with compass needles. Then the red marks would come and, inside them, the growing spines.

One evening, nearly a year after his first attack, Paul’s wife was
soothing his back with surgical spirit when she noticed that the cotton swab had gathered a bizarre blue-black haze from his skin. Paul dressed quickly, drove as fast as he could to Maplin’s, bought a microscope and placed the cotton beneath the lens. He focused. He frowned. He focused again. His mouth dropped open. Dear God, what
were
they? Those weird, curling, coloured fibres? He opened his laptop and Googled: ‘Fibres. Itch. Sting. Skin.’ And there it was – it must be! All the symptoms fit. He had a disease called Morgellons. A
new
disease. According to the website, the fibres were the product of creatures, unknown to science, that breed in the body. Paul felt the strong arms of relief lift the worry away. Everything was answered, the crucial mystery solved. But as he pored gratefully through the information on that laptop screen, he had no idea that Morgellons would actually turn out to be the worst kind of answer imaginable.

Morgellons was named in 2002, by American mom Mary Leitao
, after she learned of a similar-sounding (but actually unrelated) condition that was reported in the seventeenth century, in which children sprouted hairs on their backs. Leitao’s son had been complaining of sores around his mouth and the sensation of ‘bugs’.
Using a microscope
, she found him to be covered in red,
blue, black and white fibres
. Since then, experts at Leitao’s Morgellons Research Foundation say they have been contacted by over twelve thousand affected families. The educational and support group The Charles E. Holman Foundation claim there are
patients in ‘every continent except Antarctica’
.
Even folk singer Joni Mitchell has been affected
, complaining to the
Los Angeles Times
about ‘this weird incurable disease that seems like it’s from outer space … Fibres in a variety of colors protrude out of my skin … they cannot be forensically identified as animal, vegetable or mineral. Morgellons is a slow, unpredictable killer – a terrorist disease. It will blow up one of your organs, leaving you in bed for a year.’