When I wrote about YouYou Tu, the Chinese scientist who won the Nobel Prize in Physiology or Medicine for her successful identification, isolation, purification, and validation of Artemisinin, an antimalarial medication that was quite effective. It was also derived from an herbal remedy used in traditional Chinese medicine (TCM), which has led a fair number of TCM advocates to portray this Nobel Prize as a “validation” or “vindication” of TCM. It wasn’t. Nor was it a validation of naturopathy or herbalism, as has been claimed. It was a validation of the good, old-fashioned science-based medical research discipline of pharmacognosy, or natural products pharmacology. Not that this has stopped a number of quackery apologists from arguing these things and saying that this Nobel Prize means that we should take a closer look at Chinese medicine. Never mind that what passes for “TCM” these days is really the result of a retconning of Chinese folk medicine by Chairman Mao back in the 1950s.
A reader sent me just such an example of TCM apologia in the wake of the announcement of the Nobel Prize being awarded to Tu. It comes in the form of a radio show broadcast on Wednesday on WNPR in Connecticut, which is part of the Connecticut Public Broadcasting Network. This was a particularly misguided bit of radio, courtesy of The Colin McEnroe Show, entitled Is It Time to Take Chinese Medicine More Seriously? One can’t help but invoke Betteridge’s law on this one. The panel discussing this question included:
- David McCallum – Licensed Acupuncturist and practitioner of holistic healing methods at the Chi Healing Center in Canton, Connecticut. He’s a graduate of Nanjing University of Traditional Chinese Medicine in China
- Mary Guerrera – Professor of Family Medicine, Director, Integrative Medicine in Dept. of Family Medicine, UConn Medical School
- Vitaly Napadow – Associate professor at the Martinos Center for Biomedical Imaging at Massachusetts General Hospital and Harvard Medical School. He’s also President, Society for Acupuncture Research.
- Michael Kelly – Cancer survivor who has benefited from Chinese medicine
- Elizabeth Curreri – Owner, Curreri Public Relations
Yep. Not a skeptic in the bunch. I haven’t heard of any of these people; they’re clearly local and not national heavy hitters, but that doesn’t stop them from laying down the usual line about TCM being more holistic.
If there were any doubt that the answer to the question posed in the title would be a resounding “Yes!!!” the very beginning of the broadcast (which can be streamed at the link), where there is a conversation in the first couple of minutes between the producer Chion Wolf and McEnroe. The Wolf starts by praising Nexium and going on and on about how taking pharmaceuticals is the American way. McEnroe tells here that those pills don’t address her real medical problems. The topic of TCM is brought up, and she asks McEnroe how TCM can be so great if it doesn’t have commercials in which an announcer intones a bunch of side effects rapid-fire. Overall, this opening segment is a pretty pathetic attempt at humor, but it does serve the purpose of setting out right from the beginning exactly what the viewpoint of the show would be in no uncertain terms. This will be a 50 minute commercial for TCM.
Right off the bat, McEnroe makes a huge error of history. Telling the story of James Reston, the New York Times reporter who came down with acute appendicitis in 1971 while on assignment in China, first he claims that TCM didn’t do too well under Chairman Mao. Wrong, wrong, wrong, wrong. It was Chairman Mao who, as part of his “barefoot doctors” program, resurrected Chinese folk medicine, rebranded it as “traditional Chinese medicine,” and tried his best to “integrate” it with “Western” medicine. As I like to say, he retconned TCM into what it is today. At least he didn’t gush over the claim that Reston had pain relieve mostly from acupuncture. Then McEnroe expresses surprise that the Nobel Prize went to a practitioner of TCM. Again, wrong, wrong, wrong. Tu was not a practitioner of TCM; she attended what is now Beijing Medical College in the Department of Pharmaceutical Sciences, and graduated in 1955. Later Tu did train for two and a half years in traditional Chinese medicine at what is now the China Academy of Chinese Medical Sciences in Beijing. All of this was before she undertook her research into Artemisinin. In any case, as far as I can tell, Tu was a researcher, not a practitioner, of TCM.
McEnroe starts out by asking McCallum about TCM, revealing that he has been treated by McCallum. Big surprise, eh, that he is a believer in TCM? Not really. In any case McCallum apparently suffered as severe injury to his back in high school football and didn’t want the surgery that they were proposing for him; so the ended up. McCallum, of course, is an acupuncturist who actually trained in China. He also claims that he didn’t believe in acupuncture at first, thinking all the stuff about qi was just nonsense (which it is). He started to believe it when he witnessed a patient’s back spasms get better after needling an acupuncture point behind the knee. He then “tested this theory” on many patients, apparently blissfully unaware of the phenomenon of confirmation bias, and became a believer.
Next up is Mary Guerrera at UConn. Now, if there is a specialty that seems particularly prone to woo, it’s Family Medicine, unfortunately (with oncology probably running a close second). Her job, clearly, was to promote the ubiquitous message among believers that “complementary and alternative medicine” (CAM) and “integrative medicine” are becoming more popular and are the wave of the future. Of course, my retort to that is that integrating quackery with medicine does not make the medicine better, but that apparently has never stopped advocates of integrative medicine before. Like the National Center for Complementary and Integrative Health (NCCIH, formerly the National Center for Complementary and Alternative Medicine, or NCCAM), she touts acupuncture and TCM as a solution for an “epidemic” of chronic pain. Of course, whenever I hear the claim that there is an “epidemic” of chronic pain, I wonder whether there really is more chronic pain in the US than there was in years past or whether what we’re really seeing is an epidemic of opioid use and overuse of opioids. Be that as it may, the answer to such an epidemic, if such an epidemic exists, is not to start treating chronic pain with quackery, as tempting as that option might look. It’s to do the hard work in terms of research in order to figure out better ways of treating chronic pain.
Guerrara is, as I like to mention, a quackademic. She’s in medical academia, but she integrates quackery with conventional science-based medicine to offer quackademic medicine. I also can’t help but notice that McEnroe might have a rather distorted view of how popular acupuncture is. He claims that it’s hard to find someone who hasn’t had acupuncture at some point in his life. If you hang out with people who are woo-prone, that’s probably true, but in reality use of what I like to refer to as “hardcore” CAM, like homeopathy or acupuncture, has remained pretty much flat for many years. For instance, in the 2015 National Health Interview Survey showed that only 1.5% of the population had used acupuncture in the last year, virtually unchanged over the last decade.
Hilariously, McCallum discusses how all that stuff about “wind” and the five elements in TCM are really metaphors. For instance, to him qi is not one thing but is a metaphor for all the unseen things that happen because science did not yet understand what made blood flow, for instance, or muscles move. So to him the ancient Chinese came up with metaphors for this as “energy.” This is a profoundly silly argument, of course. Just because you call it qi or “wind” or whatever doesn’t make it any less vitalistic, and TCM is rooted in vitalism. Risibly he claims that ancient Chinese had explanations for the “interrelatedness” of symptoms that explain things that modern medicine can’t.
Because, I guess, everything is related, at least when it’s convenient.
Guerrara flails discussing qi. For instance, she says that “Western medicine” measures all sorts of energy, as it does when we measure EKGs, EEGs, and the like, which is trivially true, as is her observation that the body has a magnetic and electrical field. It’s a good thing that, as I was listening and typing last night, I hadn’t just taken a drink, or Guerrara would have owed me a new laptop. This is a seriously ignorant thing to say, and here’s why: The energies that she discusses can be measured quite accurately. We know they exist. You hook up electrodes to the chest and you get an EKG. You hook up electrodes to the head and you can measure an EEG. The patterns of these energies mean something, something that’s been studied and validated over many decades. They are reproducible. They are also predictive; changes in them can signal disease or dysfunction. In marked contrast, no one has ever demonstrated the existence of qi, Guerrara’s attempt to link qi to biomagnetism and bioelectricity notwithstanding. Qi, “metaphor” or not is basically a magical force or “energy” that can be invoked when it needs to be invoked and “does” whatever a TCM practitioner needs it to do. Guerrara’s comparions is utter nonsense of course, as is her invoking the concept of team care (which is a good thing) as a reason to “integrate” quacks into the team giving the care. To paraphrase Mark Crislip, adding cow pie to apple pie does not make the cow pie better; it makes the apple pie worse. Adding TCM to a team of practitioners of science- and evidence-based medicine is the equivalent of adding cow pie to apple pie.
Not that the entire segment was worthless. Guerrara does point out the importance of physicians knowing what supplements and herbal medicines their patients are taking, which is an observation that virtually no doctor could disagree with. None of it validates herbalism or TCM. More amusing is her statement that you should find a practitioner who is well trained. From my perspective, “well-trained’ in quackery is not reassuring.
Next up, McCallum tells us that we must embrace the body’s “innate wisdom.” I don’t know about you, but from my perspective the body’s “wisdom” leaves much to be desired. He views acupuncture as a “signal,” which is hard to argue with. After all, sticking needles into the skin will send a signal, mainly a pain signal. In any case, to him this signal is received and translated to cause “reaction throughout the whole system.” He compares this to the old Chinese way of thinking of it, by which sticking needles in “meridians” somehow redirects energy (which is a metaphor) somehow causes effects.
Vitaly Napadow then chimes in. He’s a neuroimager. The whole discussion leading up to his appearance annoyed me, I must say. Basically, it’s a whole lot of false equivalence. McEnroe (and later Napadow) talk about how there are people who “believe” that acupuncture doesn’t work. There are people who “believe” that it “works” through placebo effects. There are even people who “believe” that acupuncture works the way TCM believers say, through redirecting the flow of this invisible, undetectable “life energy” (or qi).
Of course, no discussion of acupuncture is complete without someone like Napadow discussing neuroimaging, such as functional MRI. Here’s my view on this sort of thing. If you stick a needle into the body, of course there will be changes in the brain! You’ve just caused pain, and pain is the sensation that results when a painful stimulus activates a nerve that sends a signal back to the brain that interprets it as pain. Indeed, the surprising thing would be if there were no changes in activity in specific parts of the brain in response to acupuncture. Napadow says that “he loves things that work” and doesn’t necessarily care how they work. That’s rather a problem, isn’t it, given that there’s no compelling evidence that acupuncture works—for anything.
I wonder if Steve Novella knows about this. (Actually, I know he does because I sent him a link.) In any case, this show was basically a propaganda piece for the quackery that is TCM that didn’t even bother to have a word of skepticism. David McCallum and Mary Guerrara ruled the roost, and Vitaly Napadow invoked dubious brain imaging studies as scientific evidence that there must be “something” to acupuncture. All of them implied that TCM had predicted things that “Western medicine” is only now discovering and that TCM can successfully treat things that “Western medicine” cannot (like chronic pain).
I frequently complain about false “balance” in reporting, but this show was no balance at all. Sure, occasionally McEnroe would offhandedly mention that “skeptics would say,” but only as a softball pretext for TCM believers to respond. His show had no balance at all; it was basically a 50 minute infomercial for David McCallum’s TCM practice. For shame, WNPR!