Huffington Post is notorious for publishing anti-science garbage. But I don't think anything they've vomited into the Webosphere is as egregiously misleading and anti-scientific as this piece by one Robert A. Kornfeld in which he purports to let us all know exactly why your physician's belief in the efficacy of modern medicine is a myth and in which he exposes an ignorance about genetics so profound that I may lose hope in humanity.
Before I take each of his "myths" one at a time, let me give some background on the good doctor himself. Dr. Kornfeld, you see, is a podiatrist. He is a foot doctor who, by the way, has a "holistic" (oh, that word. That woo-ey, woo-ey word) practice in which he promises to treat everything from eczema to neuropathy.
The "myths" themselves, as you will see, are not myths at all but instead are argued against the backdrop of the mythology of the World of Woo. This mythology is a dangerous one because it assumes power of the individual over physiological processes and implies that only the strong who can exert that power truly have a right to health.
Alleged Myth 1: Technology has improved healthcare.
The World of Woo has a long history of disdaining and distrusting "technology" while relying on technology. Hyperbaric oxygen chambers are an example. In this screed against technology, the good podiatrist asserts, without any sense of irony, that somehow, in spite of all this technology, "there has been an onslaught of increasing pathology." I wonder if it ever occurred to him that the "onslaught" is in large part attributable to better diagnosis through technology? Whatever his vague term "technology" means, which is unclear, he himself doesn't seem indisposed to bragging about using it himself. On his Website, he lists sonography and fluoroscopy as part of his arsenal of health-care weaponry. What does he think those are, trepanning tools?
Given the lack of specificity in his discussion of "technology," it's difficult to know exactly what aspects of technological advancement in healthcare he laments. Is it the ability to ease pain? To diagnose diseases such as multiple sclerosis earlier and earlier so that disease-modifying therapies can be employed and ward off significant disability? To operate in utero to cure otherwise fatal congenital disorders? To identify colon polyps with a disposition to become cancerous before they actually do? Oh, the humanity!
Alleged Myth 2: Inflammation is bad.
Here, the good podiatrist defends inflammation as a natural process of repair, as "actually a good thing," and argues against using anti-inflammatories. Never mind that suppressing inflammation in diseases like multiple sclerosis or rheumatoid arthritis is efficacious and produces significant relief and even cessation of the disease process. Never mind that chronic inflammation is responsible for atherosclerosis and a host of other significant disorders. The good podiatrist argues for inflammation as beneficial, but what he ignores is the distinction between acute and chronic inflammation. What he gives us here is the classic World of Woo argument that "nature does it, so it's OK." Nature is responsible for diseases from cancer to autoimmune disorders to atherosclerosis to osteoporosis. Just because Nature does it doesn't somehow make it good. Nature doesn't give a shit.
Alleged Myth 3: Genetically coded diseases are unavoidable.
This particular section provides an excellent example of two issues that we should really work harder to overcome. Issue 1 is science education in this country. If Kornfeld is an example of what someone trained in some kind of medicine thinks about genetics, then perhaps it's a losing battle. Issue 2 is writing about science. Don't do it if you simply have no idea what you're talking about. In the World of Woo, neither of these matters. There are facts and data, and then there is the magical intuition that trumps them.
I can't take this part by part or this post would become an epic. I'll just take a couple of examples.
Let's take a closer look at this issue. If having a gene for any illness condemns you to having that disease, then why are you not born with the disease you are coded to have? Why isn't every person who carries a gene for disease suffering at all times from that disease? The answer is that all genes do not express themselves at all times and many never do. There must be a reason why the body would call upon a gene to express itself. Otherwise, none of us would be able to survive the onslaught of genetic expression. So what is it that causes a gene to express itself? If you consider for a moment that diseases are just a complex of symptoms being incorporated by the body in an attempt to protect itself from tissue destruction and/or imminent death, you may begin to get a clearer understanding of what I am trying to say. Once we begin to pay attention to the reasons that a gene might express itself, we may be able to prevent that gene from releasing its code for illness.
First of all, the good podiatrist assumes that having a gene mutation that confers risk for a disease is the same thing as have a genetically conferred disease. He talks about gene mapping, by which I think he means association studies, in which the presence of specific sequences is correlated with the presence of specific disease states. These correlations are expressed as risk. For example, I have about four times the risk of specific autoimmune diseases because I have a few mutations associated with increased risk. Do I have all of these autoimmune diseases? No.
Kornfeld takes this information--sort of--and uses it to argue that having the "gene" as he calls it (what he really means is "allele" or "mutation") doesn't mean you'll get the disease. Unless we're talking about Mendelian inheritance here, he's right. But he asks a question that I'd find hilarious if it weren't so wall-eyed nutty: "Why are you not born with the disease you are coded to have?" In other words, if you're carrying around BRCA1, which is strongly associated with breast cancer, why aren't you born with breast cancer?! I guess the first reason would be that you're not born with breasts. ETA: Timing of development, timing of gene interactions with hormones and other signaling molecules, timing of growth, time itself...they are all factors in the disease process.
He then, in the above, describes the body as "calling upon a gene to express itself." As it happens, many genes involved in cancer are genes the body expresses at some point in every cell. They're expressed because they're necessary to growth and life. Kornfeld tries to argue above that something you do as a person in your life "calls upon the gene to express itself." This is a classic World of Woo tactic of "blame the individual for the disease." It's YOUR FAULT YOU GOT BREAST CANCER, not the fault of the GENE YOU FORCED TO EXPRESS ITSELF!
He then goes on to say that if we could only understand the reasons a "gene might express itself, we may be able to prevent that gene from releasing its code for illness (italics mine)." Genes don't release a code. Genes are the code. They are not a code for "illness." They are a code for proteins. Alterations in the code can lead to proteins that don't do their jobs correctly, which can lead to illness. That, by the way, is a natural process, so in Kornfeld's lexicon, it oughta be just fine. But it isn't, and You, according to Kornfeld, are the one at fault.
He keeps calling disease the "body's way of protecting itself from rapid destruction of tissues or imminent death." I think that generally, the medical profession, biologists, and other people who actually study the mechanisms of disease would describe disease itself as involving a destruction of tissues or imminent death.
At the end of this section, Kornfeld asks a series of what appear to be rhetorical questions. "Are we treating cancer by cutting it out?" Um, yes, unless we treat it with radiation or chemotherapy. He asks about suppressing chronic inflammation in arthritis and using coronary artery bypass grafts for heart disease, asserting that these techniques don't "cure" disease and that what we really oughta do is prevent "genetically coded" diseases, presumably by force of sheer willpower, in keeping with the powerful World of Woo belief that all it really takes to be healthy is to want it badly enough.
Alleged Myth 4: Medications improve health.
Kornfeld starts by asserting that USians are the most heavily medicated people on the planet. I assume from this that he means "Western pharmaceuticals" and would completely discount any World of Woo medication that someone called "natural" or "Chinese" or "alternative." 'Cause if you include all of those, I'd hazard that the most accurate thing to say is that humans are the most heavily medicated species on the planet. Anyone ever heard of betel nuts?
He refers here to drugs as "roadblocks" that physiology will eventually simply drive around, and that this driving around the roadblock leads to side effects. Horrible metaphor aside, he continues with the Woo Word of the Century, "toxic." Whenever your metaphor gets entangled upon itself, you can always cut your way through in the world of Woo if you simply toss in the word "toxic." An exclamation point or two is also useful. !!
Hilariously, he states that "if a patient has high blood pressure and is taking medication to control it, and then they cease taking it, they will see their blood pressure rise again." Ya think? He thinks this is a real coup d'grace by closing with, "Empirically, we see that the medication has not at all improved their health, just their symptoms." How can someone who claims to be a "holistic" healthcare practitioner not see the irony in trying to separate "symptoms" from "health"?
Alleged Myth 5: Childhood immunizations protect us from serious disease.
After picking up the pieces from my exploded head, I forced myself to read this one in its entirety. Once again, given this tsunami of Woo bullshit, I'm forced to home in on just a few examples.
In years gone by, many children were afflicted with polio, measles, mumps, Rubella, influenza, small pox, diphtheria, whooping cough and others. Of course, the majority of these children recovered without incident (other than polio, which caused permanent nerve damage most of the time), but there were some children who had serious sequelae and even some who died from these diseases. Modern science discovered a way to confer immunity on these children so that they would never become afflicted with these diseases, and for the most part, it has been successful. The question is, at what price?
I am so sick of this tired anti-vax trope that these diseases somehow aren't bad just because a few children die because LOOK AT ALL THE ADD, ADHD, AND AUTISM THERE IS NOW!! To use a Greenfieldism, they say, "I point to vaccines. I point to ADHD and autism. That's all."
What's the price of vaccination? Oh, lives? Millions and millions of saved lives? I won't expend the energy to rehash here what I've written elsewhere about the importance of vaccines. You can read about their importance here, here, here (from CDC), here, and here.
The "price" of vaccines, Kornfeld alleges, is a laundry list of unreferenced increases in ADHD, autism, autoimmune diseases, and cancer. He provides not one iota of evidence to back up increases in any of these disorders. In many cases, any increase that does exist is attributable to better diagnosis or changes in diagnostic parameters. Modern medicine has cleared up many a mystery that way. Regarding childhood cancers, some increased in prevalence in the '80s but then stabilized, some have decreased, and some have shown a modest increase. The real news about childhood cancer is that survival rates have increased dramatically, probably thanks to all that useless and dangerous technology and medication (see myths 1 and 4, above).
He then turns to the bizarre concept that we are "interfering with the natural course of genetic mutation," something he bewailed (possibly without realizing it) in myth #3. His argument here also sounds strangely eugenicist, with his references to allowing a "weakening." Just as he began this "myth" with a hand wave at the millions of children who die every year from vaccine-preventable disease, he wraps up with a hint of "let them die so that human immunity can remain strong," an argument both fallacious and scary in its insouciance. He actually says, "How did mankind survive and thrive through thousands and thousands of years without being immunized?" Yep, he went there. In other words, 50% childhood mortality is OK, people, as long as it means we're being "natural." The World of Woo is strangely nonchalant about all that death even as it decries a perceived, Greenfieldian association between neurological differences and vaccination.
Kornfeld closes up this alleged myth by exhorting epidemiologists to look for links between vaccines and childhood "morbidity." Because no one's ever thought of that before.
Alleged Myth 6: The double blind-placebo controlled study guarantees safety and efficacy in drug therapy.
He starts this out with, "At this point in the history of mankind...". Hey, Mr. Holistic, womenkind are people, too. Again, he argues for letting pain and suffering rule over "reaching for medicines," and asserts that somehow, the hundreds of thousands of scientists all over the world researching human disease are not "looking into the mechanisms that may be causing these symptoms." Does the good podiatrist not know about PubMed?
He then goes into an ill-informed screed against double-blind, placebo-controlled trials, which are the gold standard for testing therapies. Are they perfect? No. But they're the best we have. It beats tossing in a little eye of newt and incanting about unicorns around an open fire, I'd say. This woo-filled diatribe against modern medicine, one that kindly included all the anti-vax tropes in one place, wallows in its own irony. Woo types an excoriation of such trials with one hand even as the World of Woo wrings the other hand in horror at the absence of just such studies from vaccine trials (they do exist, of course) and from investigations of autism-vaccine links. World of Woo, you can't reasonably deride the efficacy of these trials and demand them at the same time. Actually, maybe you can.
Kornfeld struggles here to make the scientific process of drug testing look like a failure. But his very example demonstrates the practice of science and how it works. The results of clinical trials are not the be-all and end-all of drug testing. The gold standard in the short term may be such trials, but the real gold standard is simply the common practice of science: Changing conclusions as new data come in.
Non-scientists, however, or anti-science polemicists, rely instead on no data whatsoever. This entire Huffington Post piece is an exercise in ignorance and Greenfieldisms. In Kornfeld's world, it's, "I point to something, I point to something else. That's all." And that, my friends, is the real exercise in mythology, the dangerous mythology of the World of Woo.
[Photo via Flickr.]