I’ve mentioned on quite a few occasions that there’s a quote attributed to philosopher Arthur Schopenhauer that is much beloved of cranks:
All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.
I also like to point out that Schopenhauer probably never said this and just how silly the thought behind this quote is when you think about it. Unfortunately, as I was perusing Twitter yesterday, I couldn’t help but think of this quote, but not in the way quacks and cranks usually intend. Rather, I was thinking of a modified version of it to describe my feelings towards quackademic medicine.
Quackademic medicine, as you might recall, is a term first coined (as far as I can tell) by Dr. R. W. Donnell to describe the infiltration of outright quackery into academic medicine in the form of “complementary and alternative medicine” (a.k.a. CAM), which is now more commonly referred to by advocates as “integrative medicine,” the implication being that integrative medicine provides the “best of both worlds,” alternative medicine and real medicine. In actuality, it does nothing more than “integrate” pseudoscience and quackery into real, science-based medicine. In any case, in the world of quackademic medicine, one of the quackiest of the quackademics, a veritable bastion of quackademic medicine, is the Cleveland Clinic. It’s an academic medical center that has always had a lot of woo in its integrative medicine department, but in 2014 it surpassed itself by being the first academic medical center to host a traditional Chinese medicine (TCM) herb dispensary and clinic, run by a naturopath. Not satisfied with that, later that same year, it started a functional medicine clinic run by the founder and guru of all that is functional medicine, Mark Hyman, who also wrote an antivaccine book with Robert F. Kennedy, Jr. himself. Functional medicine, of course, is basically quackery gussied up to look like scientific medicine that is basically making it up as you go along. Unfortunately, that hasn’t stopped the Cleveland Clinic’s functional medicine clinic from being wildly successful.
So basically, my version of that fake Schopenhauer quote applied to quackademic medicine tends to boil down to: All quackery passes through three stages. First, it is ridiculed. Then it is violently opposed. Then it is “integrated” into medicine by credulous academic medical centers like the Cleveland Clinic.
What got me thinking about this was an incident yesterday where I happened to see in my Twitter feed responses by people I’m following to the Cleveland Clinic’s Twitter account. It wasn’t pretty. The reason it wasn’t pretty is because of what the Cleveland Clinic’s social media people were Tweeting. Mixed in among the usual self-promotional Tweets designed to promote the institution were some real howlers. For example:
Eat spinach for a firm bottom. This leafy green contains the #collagen boosting nutrient vitamin C, which keeps your skin tight and firm.
— Cleveland Clinic (@ClevelandClinic) August 23, 2016
My first reaction to this was that this sounds like something I would find being promoted by Dr. Oz’s or Oprah’s or—dare I say it?—Gwyneth Paltrow’s Twitter feed, not the Twitter feed of a respected academic medical center. What actually brought my attention to this particular Tweet were the reactions though, reactions like:
@ClevelandClinic it also has large amounts of vitamin k which can cause headaches and thicken blood
— dlmcbrayer (@dlmcbrayer) August 23, 2016
@ClevelandClinic and if you believe that we have a bridge to sell you in Antarctica!
— Rjeff (@rjeff48) August 23, 2016
@ClevelandClinic stop embarrassing yourself. Eating spinach is great. It will NOT give you a "firm bottom".
— Dr. Nimigan MD FRCSC (@DrNimigan) August 23, 2016
And perhaps my favorite:
— Emily Kean, MBA, RDN (@Keannutrition) August 23, 2016
Indeed. As was pointed out, spinach is great stuff from a nutritional standpoint, but it won’t give you a firmer bottom because of its vitamin C. It might help you get a firmer bottom if you eat more green leafy vegetables and exercise, but that’s less popular a message.
There’s more where that came from, unfortunately:
Eat these #superfoods for smoother skin:
— Cleveland Clinic (@ClevelandClinic) August 23, 2016
OK, the term “superfood” is a marketing term, not a term that has anything to do with medicine or science. It is a term that should never be seen on the Twitter account (or on other social media) of a reputable academic medical center. There is no such thing as “superfoods.” The term “superfood” implies, well, something “super” in the food, that the food is somehow far superior to most other foods or has some sort of nutrient that allows it to improve or bolster health or cure disease. Let’s listen to a real professor of nutrition:
“There’s no such thing as a superfood. It’s nonsense: just one of those marketing terms,” says University College Dublin professor of nutrition Mike Gibney, throwing on the garb of Ireland’s superfood Grinch. “There is no evidence that any of these foods are in any way unusually good.”
Yet here’s the Cleveland Clinic claiming that kiwi, pineapple, guava, and papaya are “superfoods” that’ll give you smoother skin. It’s antiaging woo combined with nutrition woo, and it’s all over the recent Twitter feed of the Cleveland Clinic. For example:
Vitamin E can be a powerful #antioxidant that helps your body fight off infection. Find it in almonds, broccoli, peanuts and spinach.
— Cleveland Clinic (@ClevelandClinic) August 24, 2016
Of course, the benefits of antioxidants aren’t nearly as clear as the Cleveland Clinic would lead you to believe, and there’s a paucity of evidence that antioxidants do anything like that. Worse, one almost gets the feeling that Oprah now owns the Cleveland Clinic:
Broccoli provides a good source of riboflavin (vitamin B2), which may help keep your lips super-smooth. pic.twitter.com/RagjaZ7gkc
— Cleveland Clinic (@ClevelandClinic) August 25, 2016
5 foods that fight wrinkles:
– Citrus Fruits
– Sweet Potatoes
— Cleveland Clinic (@ClevelandClinic) August 20, 2016
Either that, or a fashion magazine has taken over. As a friend of the blog put it:
@ClevelandClinic have you given your twitter password to a snake oil peddler? Citation direly needed.
— (((Catherina+SM))) (@justthevax) August 20, 2016
In any case, is there anything more inane, from a medical standpoint, than these Tweets from the Cleveland Clinic? A significant fraction of recent Tweets seem to be pushing vegetables more as a source of substances that’ll rejuvenate a woman’s skin, giving her a tight bottom and smooth lips and:
Chia seeds are one of the best sources of omega-3 fatty acid, and can help turn your snakeskin hands luxuriously soft.
— Cleveland Clinic (@ClevelandClinic) August 25, 2016
Seriously, who has snakeskin hands? Is that anything like snakeskin cowboys?
I suppose I shouldn’t be surprised. If you had taken a look at the webpages for the Cleveland Clinic Center for Integrative & Lifestyle Medicine, you wouldn’t be surprised either. Take a look at the services offered:
- Chinese Herbal Therapy
- Chiropractic Services
- Guided Imagery
- Holistic Psychotherapy
- Lifestyle U
- Massage Therapy
- Reiki Therapy
Take a look at what it says about reiki:
Reiki is a form of hands-on, natural healing that uses universal life force energy. The term comes from the Japanese words “rei,” which translates into universal, and “ki,” which means vital life force energy that flows through all living things. This gentle energy is limitless in abundance and is believed to be a spiritual form of energy. It is not tied to any specific religion or nationality.
The Reiki practitioner is the conduit between you and the source of the universal life force energy. The energy flows through the practitioner’s energy field and through his or her hands to you. The energy does not come from the practitioner; it comes through the practitioner from the universal source. There is no energy drain on the person giving the treatment. You may experience the energy as sensations such as heat, tingling, or pulsing where the practitioner places her hands on your body, or you may feel these sensations move through your body to other locations. This is the energy flowing into you. Some people may not perceive any change at all. Most people feel very relaxed and peaceful. Many clients even fall asleep while receiving Reiki treatment.
Elsewhere, the Cleveland Clinic asserts that it offers reiki for:
- Parkinson’s disease
- Psychological illnesses
- Chronic pain
- Digestive problems
- Stress-related diseases
Every time I go back to the section about reiki on Cleveland Clinic’s website I keep hoping that I won’t find that passage. I’ve been hoping in vain for several years. This is the same text I found on a pamphlet from the Cleveland Clinic at least seven years ago. Of course, as I’ve explained time and time again (more times than I can remember, but it’s worth explaining briefly again), reiki is nothing more than mystical magical wishful thinking. Think of it this way. Its adherents claim reiki “works” by allowing the reiki master to channel “energy” from what reiki believers call the “universal source” through him and into the patient in order to heal. Now substitute the word “Jesus” or “God” for “Universal Source.” Now what are you dealing with? That’s right. You’re dealing with faith healing. The only difference is that reiki bases its faith healing on Eastern mystical beliefs instead of the Judeo-Christian god.
And the Cleveland Clinic has been featuring a credulous description of this superstitious belief on its website for several years now, at least.
That’s not all, of course. the Cleveland Clinic also offers the Esselstyn Program, which is a plant-based diet program to “reverse heart disease” developed by Caldwell B. Esselstyn Jr., MD. He’s a former surgeon who’s become a vegan evangelist. According to his book, Preventing and Reversing Heart Disease, to reverse hear disease you must follow the following rules:
- you may not eat anything with a mother or a face (no meat, poultry, or fish)
- you cannot eat dairy products
- you must not consume oil of any kind
- generally you cannot eat nuts or avocados
As the Skeptical Cardiologist has pointed out, Esselstyn’s program is based on incredibly bad science. For example, he points out that the best randomized controlled clinical trials that we have for diet to prevent heart disease “have shown that supplementing diet with olive oil and nuts substantially lowers CAD.”
Longtime readers know that I did my general surgery residency at University Hospitals of Cleveland back in the late 1980s and early 1990s and that I got my PhD at Case Western Reserve University in the early 1990s. I know Cleveland. Even though, back in those days, the Cleveland Clinic was the bitter rival of University Hospitals, there was always respect. When I moonlighted as a flight physician for Metro LifeFlight for two and a half years, the Cleveland Clinic was a frequent destination for the transport of cardiac patients. Its cardiology and cardiac surgery programs were world class then, and they’re still world class. That’s why it’s so depressing to me to see what the Cleveland Clinic has become.