Deepak Chopra tries his hand at a clinical trial. Woo ensues.

Choprawoomed

Of all the quacks and cranks and purveyors of woo whom I’ve encountered over the years, Deepak Chopra is, without a doubt, one of the most arrogantly obstinate, if not the most arrogantly obstinate. Sure, a quack like Mike Adams wins on sheer obnoxiousness and for the sheer breadth of crankery to which he ascribes, which includes everything from quackery, to New World Order conspiracy theories, to Scientology-like anti-psychiatry rants, to survivalist and gun nut tendencies, but he’s so obviously unhinged, as well as intermittently entertaining, that he doesn’t quite get under the skin the way Chopra does. There’s something about that smug, condescending, incredibly arrogant manner of Chopra’s that grates even more in its own way than the clueless arrogance of ignorance of a person like Adams, Vani Hari (a.k.a. the Food Babe), or Joe Mercola (who appears to be far more about the money than actually believing in the quackery he sells). When Chopra tries his hand at science, woo ensues, as we shall soon see.

Perhaps the best recurring example of Chopra’s smarmy condescension coupled with magical thinking comes in his ongoing war with skeptics (most recently illustrated by his hilariously off-base “million dollar” counter-challenge to James Randi) and atheists, in particular Richard Dawkins. Given that this particular war seems to have heated up again, with Chopra having declared that he’s “pissed off by Richard Dawkins’ arrogance and his pretense of being a really good scientist,” it seems the perfect time to bring up a project of Chopra’s in which he pretends to be a scientist. But first, let’s get a flavor of why real scientists like Richard Dawkins (who, regardless of what you think of his ill-advised and offensive Twitter ramblings, is nonetheless a scientist in the way that Chopra will never be):

Boasting is not becoming of a beacon of inner peace, and Chopra knows it. I don’t want to hear him talk trash, and I ask him why he can’t just let Richard Dawkins go.

“With Dawkins, I am just pissed off. I am pissed off by his arrogance and his pretense of being a really good scientist. He is not,” Chopra says. “And he is using his scientific credentials to literally go on a rampage.”

But it’s more than that, I suggest. Chopra sits back and raises his hands, palms upward, smiling.

“I totally agree. It’s my last challenge,” he says. “It may be a very strange psychological issue.”

I don’t think there’s anything particularly strange about it. It’s incredibly obvious. Chopra, who started out as a real physician (an endocrinologist, actually) somehow got into quantum quackery and turned into a pseudoscientist and quack. Dawkins is a prominent real scientist who reminds Chopra that his blather about quantum consciousness and his ill-informed attacks on evolution are utter nonsense. Dawkins is the little kid in the fairy tale reminding Emperor of Woo Chopra that he has no clothes. There’s also a bit of resentment over colonialism, which Chopra admits right there in the interview:

When he was 6 years old, living in India, his father went to Britain to pursue higher studies in medicine.

“My mother said that the first thing you need to do when you get there is to get a white British guy to polish your shoes,” Chopra recalls. “My parents, they grew up under English colonialism. Two hundred years of enslavement, and he went to Southampton and made sure it was a white guy that had his shoes shined.”

His father sent them a letter, and Chopra recalls his mother reading it to them and saying, “See, after 200 years, your father got his shoes shined.”

Now Chopra can’t stand “these Oxford and Cambridge pseudo intellectuals,” he says, and “India has a habit of aping them. There are more fans of Dawkins in India than anywhere else. It’s the postcolonial hangover.”

So the reason that Dawkins, more so than Michael Shermer, James Randi, or the horde of skeptical bloggers who over the last decade have ripped him a new one any time he’s made major pronouncements about evolution, medicine, or universal “quantum consciousness, Dawkins irks Chopra the most of all, because not only does he bitingly remind Chopra that he is not a real scientist, but he is a representative of the colonizing English intellectuals that Chopra has hated since he was a child. In brief, Chopra has a massive inferiority complex with respect to people like Dawkins, and Dawkins is only too happy to rub Chopra’s nose in his own inferiority. Of course, in some cases, inferiority complexes are an accurate reflection of reality. Certainly, Chopra’s inferiority complex is.

As a physician-scientist, I believe can also speculate a bit from my own experience. As I’ve said time and time again, the vast majority of physicians are not scientists, and that’s OK. We physicians learn scientific facts and how to apply them to the diagnosis and treatment of patients, and that’s very important—absolutely critical, actually—but most medical schools don’t teach medical students how to think like scientists. True, we are taught how to interpret clinical studies and clinical trials, and that is science, but it also requires a somewhat different mindset than basic science. When it comes to basic science, except in a relatively perfunctory fashion (and sometimes not even then), medical students are not really taught how to interpret basic research. I experienced this myself when, after a heavy duty undergraduate major in the honors program in chemistry (which required a mentored research project in the laboratory of one of the faculty), I found myself in medical school and frustrated at how I was being taught massive quantities of new science about human physiology, pathology, and biochemistry, but that it wasn’t the same. It was very practical. It was very applied. In some subjects (e.g., anatomy, histology, pathology, and pharmacology), it was very rote. It had to be. Physicians need to know anatomy and histology before they can understand, for example, pathology. They need to understand basic biochemistry before they can understand pharmacology. It also didn’t help that teaching went on at light speed, with so much material crammed into the first two years that it’s a wonder I retained as much as I did.

The difference was again highlighted when, after my second year of residency, I entered a PhD program. There, although we did have to memorize a fair amount, the emphasis was nonetheless on the interpretation of the basic science literature and the design and interpretation of experiments. In brief, the goal of medical school is to provide to medical students the intellectual basis and knowledge necessary to be good physicians, and the goal of a good science PhD program is to teach students to think like scientists and to prepare them to be scientists at the highest level. That’s one major reason why there are often so many misunderstandings between basic scientists and physicians with respect to medical research.

It’s clear from Chopra’s ramblings over the years that he considers himself a scientist. We’ve seen such a phenomenon many times before over the years, in which a physician thinks that he is as good at interpreting science as actual scientists, in particular, for some reason, evolutionary biology. It’s not for nothing that a recurring gag over the years on this blog is my wanting to hide my face with a paper bag whenever one of my fellow physicians—or worse, one of my fellow surgeons—spouts off ignorantly about evolution. While it’s true that there are certainly MDs who are indeed excellent scientists, most are not, and it’s clear that Chopra thinks he is a scientist. Worse, he thinks he is a scientist who sees things about evolution and biology that hidebound Oxford evolutionary biologist like Dawkins have not and cannot because they do not have the imagination.

A reminder of this popped up just yesterday in the form of an article by Chopra submitted to SFGate entitled Multi-institutional Collaborative Clinical Trial to Examine Health Benefits of Integrative Lifestyle Practices at the Chopra Center for Wellbeing. The “study” being described is the Self-Directed Biological Transformation Initiative (SBTI), and Chopra claims that it will use the “latest mobile health sensors and genomic/cellular/metabolomics biomarkers” to examine these “health benefits”:

Scientists and clinicians from seven research institutions have joined together for a first of a kind clinical trial on a whole systems approach to wellbeing. Such an in-depth clinically focused study is unique because previous research studies have typically examined the beneficial effects of individual wellbeing practices – such as meditation, yoga, or specific herbal preparations – few have taken anything like a whole systems approach which simultaneously includes a number of such practices to promote improved mind-body functioning. The Chopra Center for Wellbeing has been in the forefront of integrating whole systems approaches such as Ayurveda, meditation, yoga, massage, herbal treatments, and nutrition into programs for improving health and wellbeing.

This new study pulls these strands together in the most comprehensive manner to date. By measuring the total effect of an intensive immersion into a whole systems program, the aim of the SBTI study is to see if the data will demonstrate a person’s connection to the healing process. The body’s healing system is still little understood as a whole, because of the complex inputs—thoughts, emotions, diet, stress, exercise, immune response, etc.—that affect whether we heal or not. The picture is further clouded when isolated findings overlap or contradict one another.

As I read this article about the SBTI, one question kept bouncing in my mind: What’s the hypothesis? What hypothesis is Chopra testing here? It’s a randomized trial, in which study participants will be recruited for a week long stay at the Chopra Center at the OMNI La Costa Resort in Carlsbad, CA and will be randomized to join either the Ayurveda program or a seven-day stay at the resort without treatment, which serves as the control. The Chopra Foundation website helpfully lists the study inclusion and exclusion criteria here, as well as a description the program. Examining the schedule of events, Chopra’s “Perfect Health” program includes a whole bunch of Ayurvedic massage (which can’t be too bad, I would guess), primordial sound meditation, mantra sessions, group sessions, yoga, and, I’d be willing to guess, a healthy diet.

Participants will be evaluated four times: at home prior to arriving at the Center, immediately upon arrival, immediately following the treatment program, and one month later in a follow-up assessment. The following markers will be tested:

  • RNA expression
  • telomerase activity (linked to the aging process)
  • a variety of metabolites, peptides, and neurohormones (connected to metabolism, addictions, and mood changes as well as the messaging between brain and body)
  • the microbiome (the enormous population of microorganisms on the skin and in the intestinal tract, and their collective genetic material)
  • circulating protease activity
  • mobile cardiac functioning
  • balance of the autonomic nervous system
  • assessments of mental, emotional, and spiritual wellbeing

Chopra describes the whole thing here:

This is what we in the biz call a fishing expedition. There is no real, concrete, testable hypothesis here, other than that Chopra’s woo-packed Ayurveda program is a good thing. Actually, in the video, Chopra states that the goal of the study is to “document scientifically that you can consciously direct the activity of your genes for optimal physical, emotional, and spiritual well-being, that you can consciously rewire your brain for the same purpose.” Later in the video, Chopra states:

The idea is to prove—scientifically—that your biology is a product of the choices that you make, and these choices are made every day, and that we can actually consciously create the experience of a joyful energetic body, a loving compassionate heart, a restful reflective mind, and lightness of being.

WTF? What does this even mean? How, specifically, do you measure whether or not the participants have consciously created “the experience of a joyful energetic body, a loving compassionate heart, a restful reflective mind, and lightness of being”? Of course, the choices we make affect our biology. If you smoke, you hurt your heart and lungs and vastly increase your risk of heart disease and cancer. If you drink to excess, you vastly increase your risk of liver disease. If you’re a sedentary slug who never exercises, you vastly increase your risk of developing any number of harmful conditions and diseases, such as hypertension and type II diabetes. These are trivial observations.

Of course, confirming such trivial observations, long confirmed by medical science, is not what Chopra is about. Notice his unscientific language. He doesn’t say “test the hypothesis” or “see if this program results in X and Y.” He doesn’t know what he’s looking for before he does the experiment. He only knows that it’ll be good. Rather, he says things like “prove scientifically” that his program does all sorts of wonderful things that aren’t specified in concrete, measurable ways. Instead, he’s going to shotgun measure a whole boatload of markers and endpoints, including next generation whole genome sequencing. If adjustment for multiple comparisons is not undertaken, I can virtually guarantee that this study will be “positive” in that it will find a “statistically significant” difference in at least a few markers. Because a “whole program” is being tested, it will be impossible to tell if any apparently beneficial changes observed are due to exercise (yoga), meditation, or to the special diet that participants will be consuming while at the Chopra Center. If, for instance, the diet alone is enough to produce beneficial changes in some of these markers within a week (and it wouldn’t be surprising if a major change in diet changed the bowel microbiome), Chopra will tout it as being due to the “holistic program,” all of which will be claimed to be necessary for the beneficial effects. It’s disappointing that the real scientists at the five institutions other than the Chopra Center buy into this bad science, but then these institutions are institutions steeped in quackademic medicine. So perhaps it’s not that surprising at all.

Clearly, this experiment would never qualify for peer-reviewed funding, particularly in this tight environment. Besides it’s being a fishing expedition, there appears not to have been even a perfunctory attempt to blind either participants or investigators to experimental group assignment. (I realize that it might not be possible to blind participants, but the investigators sure as heck could be blinded, and reasons for not blinding participants need to be explained and justified.) So Chopra has been using Indiegogo to raise funds. Amusingly, he’s only raised about $40,000 of a goal of $250,000. Still, even that $250,000 doesn’t sound like a lot of money to conduct a study like this, at least not if the investigators want to enroll a large enough number of subjects to obtain statistically valid results. Maybe that explains why Chopra is charging participants:

7. Q: Is there a cost to participate?

A: There is NOT a direct cost to participate in this study, however there is a program enrollment fee for Perfect Health. The enrollment fee has been offered at a discounted rate due to study requirements/responsibilities taking place during the Perfect Health program.

SBTI Perfect Health Study Group: Participant is responsible for travel expenses, hotel accommodations and a Perfect Health program enrollment fee of $2875 which includes free enrollment into Chopra Center’s Journey Into Healing program in 2015. Breakfast and lunch is included in the enrollment fee, dinner is on your own.

Control Group: Participant is responsible for travel expenses and a Perfect Health program enrollment fee of $2875 which includes free enrollment into Chopra Center’s Journey Into Healing program in 2015. The program enrollment fee of $2875 will be issued as a credit for use towards any future Chopra Center: programs/events, retail store purchases, online products, and/or massages. Credit for future use is provided since you will NOT be participating in Perfect Health during the study week. Hotel accommodations and a $30 meal voucher (dollar amount may be subject to change), for your 6 night stay during the study dates, are funded by the Chopra Foundation for the Control Group only.

Why the $2,875 fee? I can see not covering travel costs; few, if any, clinical trials cover travel costs, which is why it is important for major trials to do them at as many sites as possible. However, Chopra could easily waive the nearly $3,000 fee for his Perfect Health program. He does not. The biggest concession he makes ist that he gives those randomized to the control group a voucher towards future Chopra Center programs or to use to purchase Chopra Center merchandise. How generous. It’s sounding more and more like Stanislaw Burzynski to me. Also, when it comes to designing a clinical trial, he’s showing the competence of Mike Adams’ fumbling with a mass spectrometer.

No wonder Chopra is so “pissed” at Richard Dawkins. Chopra is not a scientist. He just pretends to be one for the benefit of his New Age, woo-loving followers. Dawkins reminds him of that. Good.