February 20, 1998


The number of quacks in a locality is an index of the character of the regular medical profession in that locality.

Robert Tuttle Morris(1857-1945)

I remember one evening, some time ago, being at my 90 year old mother's house. She was complaining that she felt listless and had no energy. Suddenly she said, "I forgot to take my vitamins!" She opened a bottle of vitamin pills and took one. In a few seconds, less time than it would take the pill to dissolve in her stomach, she brightened up: "Now I feel much better."

My mother is not alone in believing that vitamins will give you more energy and make you feel better. Enough people believe it to make the vitamin industry a very lucrative business.

Whenever a new drug is tested, precautions are taken to control for the placebo effect. Placebo is a Latin word meaning "I shall please." The placebo effect is the phenomenon where a patient is given a sugar pill and feels better because he truly believes that he is getting a drug that is helping him.

To control for the placebo effect, drug trials are done that are "double blind," meaning that neither the patient nor the doctor knows which patient is getting the drug and which one is getting the placebo (the sugar pill). The reason that the doctor also has to be kept in the dark is because the patient can sense the doctor's expectations. In most drug trials, some 20 or 30 percent of the people getting the placebo will report being significantly improved. If you use a group of suggestible people, percentages can be much higher.

There is an immense difference between a drug that will actually make you better and one that merely makes you think that you are getting better. Think about the cost of a bag of candy pills and the cost of a real drug. If someone is selling you a sugar pill for the price of a useful drug, you are being swindled. Even if it does make you feel better, you are still being swindled.

Millions of people are being swindled, and they are being swindled of their own free will and seem to be blissfully unaware that they are being swindled.

What makes it more pathetic is that insurance plans are quite willing to pay for those swindles, including the medical insurance that employees of Laytonville's schools are getting.

One major problem is that the borderline between legitimate medicine and medical quackery has always been somewhat fuzzy. In my childhood, almost all of the remedies for childhood diseases that were prescribed by a physician were no better than what was sold by the snake oil salesman; the out and out quack. Since then, there have been great advances made in medical science. However, much of what is practiced is little more than the use of the placebo effect. In other words, the gap that separates the legitimate medical practitioner and the quack can sometimes be a very small one.

In this column, I am not considering the physician's useful, and very necessary, role as a comforter. It is very important and I intend to discuss it at a future time.

What the ophthalmologist or optometrist sells almost always corrects your eyesight problem. You get what you pay for. It is a completely honest transaction. Contrast this to the hogwash peddled by the quacks, which remedies nothing even though it salves your feelings.

Most of what a competent surgeon does is legitimate and often effective treatment. What some physicians do may seem to be indistinguishable from what the quacks, acupuncturists, chiropractors and holistic practitioners do. Some physicians, who have spent considerable time and money on a medical education, decide to make their living by deluding their patients; which seems to be exactly what many people want.

I would like to conclude with a quote from my 1974 book The Topic of Cancer :

The harm that a cancer quack does is indirect, in that he keeps people from receiving competent diagnosis and treatment which might cure whatever he has while it is still curable. Maybe I'm being too harsh on the cancer quack; he exists by the grace of the stupidity of the people who go to see him. It takes two to play any game, and if a person wants to commit suicide, why blame the one who hands him the gun?

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