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admin 08.05.2015

Should we respect David Katz’s authority when he pontificates about how misguided advocates of science-based medicine are?
Last week, my friend Jann Bellamy discussed an unfortunate special supplement of the American Journal of Preventative Medicine (AJPM) entitled Integrative Medicine in Preventive Medicine Education.
David Katz’s bragging reminds me of the threat display of Chlamydosaurus king, or the frilled-neck lizard, except that his neck frill consists of pages of his CV.
Besides, given the rise of quackademic medicine, defined as the infiltration of quackery into academic medical research and practice, coupled with the existence of the National Center for Complementary and Integrative Health (NCCIH), formerly known as the National Center for Complementary and Alternative Medicine (NCCAM, a much nicer abbreviation), having federal grants and publishing a couple of hundred papers are no guarantee of being quackery-free. Moving on to the “fluidity” that has proven such a diverting target for the slings and arrows of my science-based colleagues, what did I mean?
One need not be a clinician, wrestling with especially challenging patients or otherwise, to see the relevant spectrum of decisions. The sounds, the colors, and the fields exist; and biologies other than our own can access them.
This is a straw man so massive that the heat derived from burning it could be used to generate electricity for the world for decades, much like Katz’s hot air boasting about his credentials. Unfortunately, for something like energy healing or homeopathy, both of which Katz has advocated, new science much more revolutionary than the theory of relativity replacing Newton’s laws would be required to make them plausible.
We have the inherent fluidity of scientific evidence to thank for every Nobel Prize in science.
We need no help from fanatics to know there is hucksterism in the world, or bathwater in the tub. Integrative medicine, a concept developed over the past few decades, refers to the fusion—by various means, and to varying degrees—of conventional medical practice and some of the practices that fall under the complementary and alternative medicine (CAM) rubric. Doesn’t this sound like he’s filling in the gaps in medicine with whatever fairy story appeals to him? Jann also notes that if it is true that integrative medicine = SBM + CAM, then what’s left of integrative medicine if CAM is left out. If David Katz postulates that some humans may have a rare ability to detect and manipulate energy fields and perform Reiki, how does he explain that this rare ability can be acquired at a weekend seminar in a hotel meeting room? I would be impressed with Katz having written one book and co-authored another, except that Suzanne Somers has written dozens of books! Personally I think any MD who subscribes to any aspect of homeopathy should just be stripped of their license and made to live on a diet of homeopathic food for 40 days.
Are we prepared to know in the absence of evidence that no such person endowed with a heightened sensitivity blunted in the rest of us, could interact with the energy field produced by a body in close proximity? AFAIK, Galileo and Copernicus believed in, (or at least, taught) astrology, Newton was spent years trying to convert base metals into Gold and Einstein spend years trying to show that Quantum Mechanics (the real thing, not Deepka Chopra’ version) was wrong.
Katz lauded the book’s “lyrically beautiful writing,” comparing it to the work of a veritable “who’s who” of great writers, including Plato, John Milton and Charles Dickens. That, however, does not mean that someone can learn to alter a patient’s vital signs by waving their hands (plus or minus chanting vaguely Sanskrit-sounding inanities). Katz is most displeased with Jann, to the point that he felt the need to lash out at her and all skeptics who question his greatness. One form of such behavior is known as threat display and consists of the animal doing something to show its strength or make it look larger and more dangerous in order to intimidate potential opponents and thereby win without having to fight. Speaking of books, I have authored one textbook exclusively about evidence-based medicine and its relationships with both research methods, and clinical decisions; and multiple editions, in the company of colleagues, of an epidemiology text much devoted to that same domain.

Katz seems to begin his rebuttals to any criticism of his advocacy for integrating quackery with medicine this way, with an appeal to authority—his authority. Well, that, too, is a matter of the published record — previously, and again in the new compilation in AJPM. As I’ve said time and time again, a competent adult can choose or refuse any treatment he or she wants, but if a patient refuses a validated science-based treatment modality it is not a valid justification for a physician to use quackery. What is most compelling is that all of these ARE perceivable to biology, just not OUR biology. No one says that it’s impossible that a human being might be able to perceive energy fields. Barring that, Katz’s likening CAM investigators to Einstein, Hawking, Copernicus, et al is risible at best. Perhaps the Spanish Inquisition is intrinsically shielded from all anticipation, because it is so improbable, even paradoxical.
The martyrs and their murderers were too much alike, subject to differing versions of comparable hooey. At which point, they will revise their fluid definition of woo, and pretend it never happened. To express his displeasure, he has rattled off a little rant over at his usual non-academic hangout and quack-friendly Internet outlet, The Huffington Post. For example, when threatened the frilled-neck lizard engages in an impressive display in which it raises its body, gapes its mouth to expose a bright-colored yellow lining, and spreads out its frill showing bright orange and red scales. The problem is that, as he has done so often in the past, he takes those points and drives right off the cliff of woo with them. Colleagues and I proposed, based on years of wrestling with complex patients, many of whom, urgent medical needs still insufficiently addressed, had tried and exhausted all of the well-supported, conventional treatments, that evidence traversed 5 key considerations. It’s also the sort of thing science-based medicine does all the time with pretty much every patient for which science-based treatments might be lacking or far less than ideal. We say that it is incredibly improbable based on what we know about the basic sciences of biology, physics, and chemistry. Katz could point me to a passage—any passage!—in the entire nearly eight year history of this blog that could be construed as saying that science isn’t fluid or that there are findings in science that are absolute and not subject to change. Apparently, Katz views himself and his fellow integrative medicine enthusiasts as scientific groundbreakers who are unappreciated. In this lamentable, historical episode, people were tortured and martyred for the heresy of their absolute faith in unknowable things, by people with absolute faith in unknowable things. The engineered poliovirus does, however, release a toxin that kills cancer cells when it is in them. The same measure will serve to renounce the counsel of fools to overlook the baby in the tub, or the possibility of somewhat surprising new truths in the fullness of time.
Of course there will be statistical noise in the experiment, but the results are hardly fluid.
And if there were one, those with blunted sensitivity could use instruments to detect and interact with it. They respect what we know, and how we know it, but humbly concede the potential for it to change as new evidence accrues.
Katz haven’t been searching for evidence validating CAM therapies for a long time now.

He explored thought experiments to try and discover holes through which that theory would be visible.
Clinicians who wrestle with complex patients on a daily basis are more than familiar with such questions, to the point that Katz’s argument above is basically trivial. I just know, based on cancer biology, chemistry, and physics, that it is so incredibly implausible that radio waves cause cancer, of the brain or breast or other organ, that it is reasonable, barring new evidence, to provisionally treat it as impossible. It is then up to believers like Katz—and, make no mistake, he is a believer in CAM, his protestations of being all about the science notwithstanding—to provide the evidence that a phenomenon like humans who can detect and manipulate other humans energy fields actually exists. Katz starts his article reminds me very much of an academic equivalent to the display of the frilled-neck lizard in the way he puffs himself up and tries to assert his academic dominance over us by showing us his science bona fides. What I respect far more than authority, however, are science, critical thinking, and compelling arguments.
Here is a man who is quite comfortable working with naturopaths, whose specialty is a cornucopia of mutually contradicting pseudosciences and quackery. It would also help if they could actually demonstrate that a human energy field, of the sort claimed to be manipulated by energy healers and TCM practitioners, actually exists, which they can’t.
In other words, it’s a lot less likely that central laws, such as the three laws of thermodynamics, will be overthrown than it is that more recent and tenuous findings will be. Substitute the pages of one’s CV for the impressiveness of the neck frills, and you get the idea.
Given that, for example, for homeopathy to be true huge swaths of conventionally understood physics and chemistry would have to be radically rewritten, there would be many Nobel Prizes involved in such a discovery.
Heck, I’m not even a full professor yet (although, barring any unforeseen glitches in the process, that situation should be rectified by spring). In other words, David Katz needs to spend more time burnishing his arguments and less whining about upstarts who dare criticize his genius.
My favorite example of this is how the theory of relativity supplanted Newton’s laws.
The ham-fisted way Katz explains the comparison also inadvertently conflates science and religious belief. Newton’s laws are, in fact, still used for most calculations of motion used in aeronautical engineering because relativistic corrections are not necessary until velocities reach a fraction of the speed of light sufficiently large to exceed the precision required for a task.
That’s why I rarely dwell long (if I mention them much at all) on my own qualifications, even when I’m writing about topics that fall under the purview of my specialty that I might reasonable be considered to be an expert in, such as screening mammography. Basically, at most speeds that humans can observe and use, the theory of relativity reduces to Newton’s laws.
Is Katz implying that all those scientists he lists underwent adversity for their faith in something unknowable? In my experience, it’s almost always an indication that the arguments to come will be weak. Even if the experience that leads me to that rule of thumb is mostly confirmation bias, Dr.

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