The Health Wars

First, let me say the happiest day every two months is when my new issue of Skeptical Inquirer arrives, and the saddest day is the day I finish reading it (which sometimes occurs the same day). I admit when I first saw the subject of your “Health Wars” issue (September/October 2019), I did not expect to find it as thoroughly interesting and informative as I did. I suppose I have heard of all these claims at one time or another, but having them all gathered in one place was very compelling.

I found Victor Benson’s piece on the National Geographic Society’s books to be especially good.

While I recognize that there are too many claims out there to investigate all of them in a single issue, I was disappointed at the absence of a review of the claims for apple cider vinegar, which is claimed to cure everything from A to Z. I hope a future issue might explore the actual benefits of this miracle product (personally, I find it useful in salad dressing).

Thank you very much, and I eagerly await the next issue.

Katherine Rogers
North Potomac, Maryland

I just finished reading your September/October 2019 issue regarding medicines good, bad, and indifferent. It reminded me of my childhood and teens in the 1940s–1950s. I would visit my Dad, A.P. Warthman, a well-respected physician in Detroit, and observe some of his interactions with patients. He had a large jar of pink “pills” on his shelf, and whenever a patient would complain of one thing or another and there was no evident problem, he would offer a packet of those pink pills. “Take these and see if it makes you feel better,” he would say. In most cases the patients felt a lot better and always asked for more of the pills when they visited. When there were no patients around, I would be allowed to take a couple, as they were all just pink candy.

Edythe Robinson
Starke, Florida   

I do not know if most people are aware, but back in 2015 the National Geographic Society sold its media properties and publications to National Geographic Partners LLC—majority owned by 21st Century Fox—controlled by Rupert Murdoch (a climate change denier, among other things). Earlier this year Disney took over stewardship of National Geographic Partners when it acquired 21st Century Fox. To me, this indicates that possibly we should be very careful when we now see books and magazines from National Geographic. It used to be that you could trust the information presented—but maybe not anymore.

Kathy Petersen
Granite Bay, California

No one should be surprised by the decline of standards of National Geographic after it was purchased by the ethically challenged Rupert Murdoch. The magazine, along with Fox News and The Wall Street Journal, have been part of the Murdoch empire for quite some time now. How ironic that in the era of MAGA, Fox News, America’s most watched news outlet; The Wall Street Journal, America’s most important business newspaper; and the National Geographic are foreign owned!

James Williams
Kent, Ohio  

Editor’s note: As of March 20, 2019, National Geographic Partners is now owned by the Walt Disney Company; see our News and Comment “Wither National Geographic?” in this issue.

I have no confidence in SCAM [so-called alternative medicine], for the reasons cited in your excellent issue. But I am a skeptic even of skeptics. 

Consider: Like SCAM, conventional medications often do not work. Or they work via often poorly understood mechanisms (as one can learn from reading the fine print in the literature pamphlet that comes with a prescription). Or people get better with little or no certainty that the medication helped—maybe the ailment was going into remission anyway, or there was a placebo effect. Prescription drugs can be harmful (just listen to the long lists of side effects in the TV ads), even lethal. They have caused birth defects. But it is hard to imagine a class of medications more dangerous than legal psychotropic drugs, which are prescribed to children, although the meds can have a dozen side effects and, while purporting to cure depression, can sometimes cause suicidal thoughts. Many drugs, even if approved, are later deemed so unsafe that they must be recalled. Clinical studies can be biased or flawed, the data faked or fudged, the study impossible to replicate. “Science-based” is a bar that is sometimes not reached. 

I invite a reply from one of your medical specialists. Yes, SCAM postulates a lot of imaginary entities. But other than that, how are the two classes of therapies truly different?

Alan M. Perlman
Rindge, New Hampshire

Harriet Hall, MD, responds to Perlman’s letter:

Good skeptics are skeptical about everything, including other skeptics. Science-based medicine is skeptical about everything and has frequently revisited long-established treatments, found new evidence that they weren’t really effective, and has stopped using them. Your example of drug recalls is a prime example of real medicine responding to new and better evidence.

If a medication has been shown to work, we don’t necessarily need to know “how” it works; we used aspirin for decades before we began to understand its mechanism of action. Conventional medications have to prove efficacy and safety to the FDA before they can be approved for marketing. That doesn’t mean they always work reliably for every individual. We can never be sure a given medication was what cured an individual patient; that’s why we have to do controlled clinical studies to compensate for confounders such as remissions and placebo effects. Studies can only show a medication is more effective than a placebo for the population studied; they can’t predict how each individual will respond.

All medications that have effects will also have side effects. Treatment decisions must balance the risks against the benefits. Science-based medicine is well aware of the many factors that may invalidate the results of clinical studies. Science is an ongoing, self-correcting collective effort that eventually sorts out the truth. It isn’t perfect, but it’s a heck of a lot better than SCAM. SCAM is all too willing to accept flawed evidence, and it places undue emphasis on unreliable personal experience and anecdote. Unlike conventional medicine, SCAM has no culture of self-criticism and never stops using a treatment. Case in point: homeopathy was debunked well over a century ago but is still thriving. Conventional medicine can boast of many triumphs. It has changed HIV/AIDS from a death sentence to a controllable chronic disease that doesn’t even shorten life expectancy. It has already developed an effective vaccine against Ebola. What has SCAM ever accomplished? There can be no comparison.

Opioids: Good, Bad, Ugly

Regarding the informative article “Opioids: The Good, the Bad, and the Ugly” by Dr. Harriet Hall (September/October 2019), I want to disagree with one assertion, “We are in the midst of an opioid epidemic” propelled at least partly by opioid prescription abuse.

         Yes, we physicians, urged on by “Big Pharma,” did for too many years over-prescribe. But our profession is doing better. Between 2012 and 2017, the U.S. medical opioid prescription rate per 100 patients dropped from sixty to forty per person. (Opioid painkiller prescriptions in Britain also started to decline in 2016.) Despite the shift to more lethal fentanyl agents noted by Dr. Hall, U.S. opioid drug overdose deaths dropped from 72,000 to 68,500 between 2017 and 2018 (U.S. Centers Disease Control and Prevention, 2019, Statistics, opioid overdose, Data Overview).

These data suggest we are closer to the end than to the “middle” of the lethal opioid misuse epidemic.

Peter Barglow, MD
Berkeley, California
Dr. Barglow wrote “Confessions of an American Opium Prescriber” in our July/August 2019 issue.—Editor

Magic Waters?

I liked Joe Nickell’s “Magic Waters” article (September/October 2019), but some magic seems to have made its way into his geography. The River Jordan is completely landlocked, flowing southward through the Jordan Valley and terminating in the Dead Sea.

John Gee
Singapore
Republic of Singapore

I’m sure many readers will point this out, but the Jordan River does not connect the Dead Sea to the Mediterranean except possibly by rainwater condensed from clouds formed over the Mediterranean that move east. The River Jordan flows into the Dead Sea, from which nothing escapes except mineral salts from evaporation ponds that are mined commercially and evaporation of the lake itself. There was some speculation that water could be added to the Dead Sea to keep it from actually dying, but this was from a canal or aqueduct from the Red Sea—not the Mediterranean.

Frank Archer
Delta, B.C., Canada

Gloucester Serpent

Regarding Joe Nickell’s analysis of the 1817 Gloucester Sea-Serpent Mystery (September/October 2019), I believe he missed an interesting point regarding the strange southern range of the narwhals. The previous year, 1816, was also known as the year without a summer because of the unusually cold weather caused by volcanic dust in 1815. I wonder if an oceanographer could confirm whether (or weather!) changes in ocean temperature could be offset by a year at least, explaining the range of these animals usually found in colder waters.

Joseph Gagné
Historian
Québec City, Canada

Although I enjoyed reading Joe Nickell’s article about solving the Gloucester sea-serpent mystery, two significant pieces of information were not addressed.

First, there was a new book about this same subject featured in the “New and Notable” section of this very issue of Skeptical Inquirer, titled Disentangled. This book concludes that the animal was most likely “a marine animal that was entangled in fishing gear and other marine debris.” Nickell did not address this book or the reasons a new book on this subject reached such a different conclusion.

Second, there is the unusual situation of the “Sea Serpent” being sighted several times in 1817 and 1819 and then never seen again. In this case, I believe that I have an explanation that bolsters Nickell’s case that the “Sea Serpent” was a group of narwhals. As Nickell notes, narwhals are normally found above the Arctic Circle. However, 1817 and 1819 were not usual times. If you Google “year without a summer,” you will find that not only was this time period right at the end of the little ice age, but it occurred right after the immense volcanic explosion of 1815 at Mount Tambora in Indonesia that led to “the year without a summer” in 1816.

From the point of view of a narwhal, from 1816 to 1819, the Arctic Circle moved south to Gloucester. Then, after the sulfates dispersed, the Arctic Circle returned to its usual location, again, from the point of view of a narwhal. This unusual happenstance would explain why the narwhals would suddenly appear in an area that is far south of their usual habitat and, also, why they never came back.

Ben Fishler
Dennis, Massachusetts

Anomaly Hunting by Satellite

In his column “Anomaly Hunting with Satellite Images” (July/August 2019), Benjamin Radford responds to V. Corbett on a couple of unusual Google Earth images Corbett submitted for comment. 

The images in question look to me like typical overlaps of satellite images taken on different passes over a region in question. The algorithm for overlaying images is imperfect, and we frequently see artifacts such as those depicted in the ocean views. Oceans do not have distinct spatial features that support careful overlapping of images, so portions of the Google Earth views often show difference of illumination or imprecise colorations. There may also be imprecision in spatial filtering to remove background noise from atmospheric scintillation.

Bernard Roth
Santa Barbara, California

Were Mars’s Canyons Visible?

I appreciate the comments by Klaus Brasch in his response to my letter “Those Martians Canals Again” (Letters, May/June 2019), as well as bringing to my attention the two sources A Traveler’s Guide to Mars by William K. Hartmann (Workman Publishing, 2003) and Mars: The Photographic Story by Earl C. Slipher (Lowell Observatory, 1962).

Klaus Brasch is correct when conveying the quotation from Hartmann’s book that “Proof that some of Schiaparelli’s and Lowell’s much-criticized canals were based on real features can be found in a Martian region known as Xanthe.” However, this quote does not necessarily contradict the statement that the canals reported by Percival Lowell and the martian canyon-like structures should be considered as serendipitous. In fact, the size of the canyon system at the Xanthe region is very small compared to Valles Marineris. Therefore, if the latter would be “borderline observable” via ground-based observations, the Xanthe canyons surely would not be. In fact, a careful read of Hartmann’s book indicates that he also attributes the discovery of Valles Marineris to the Mariner 9 mission.  On pages 24–25, Hartmann summarizes the various findings of that mission, including lava-covered plains, volcanoes, craters, and—yes—Valles Marineris. (William Hartmann also was the first winner of the Carl Sagan Medal from the American Astronomical Society, awarded in 1998.)

The book by Earl Slipher contains a large collection of photos with many of them of unprecedented historical value. Unfortunately, it also contains various scientific statements that from today’s perspective are not correct. Examples include his statements about the absence of tall mountains on Mars, surface water (though described as minor), and martian vegetation (pages 66, 68, 69). In that context, he also comments on vegetational seasonal variations as well as suspected metabolisms. Regarding the photos, he makes no explicit statement that Valles Marineris has previously been detected through ground-based observations. But some of the photos are suggestive. For example, the three panels of Plate V (see p. 79) show an extended dark equatorial region; beneath the panels, the map by Lowell (1905) with the martian “canals” is shown, including annotations.  The dark region depicted in Plate V globally follows Mars’s equator. However, based on the picture, that feature can be estimated as more than 1,000 km wide, a value that is more than a factor ten greater than the width of Valles Marineris. The structure could thus be associated with a martian sandstorm.

In conclusion, the statement that Valles Marineris was discovered by Mariner 9 remains valid. The problem with ground-based observations is atmospheric seeing. The apparent size of Valles Marineris can be estimated as about ten arcseconds long and one to two arcseconds wide, as visible from Earth under ideal conditions with Mars in opposition, an estimate also confirmed by Dr. Michael Endl (senior research scientist, McDonald Observatory, University of Texas System; private communication). Seeing under extremely superb conditions as, e.g., obtainable at high-altitude observatories such as on Mauna Kea (Hawaii) can deliver better results. However, facilities of that caliber were unavailable at Schiaparelli’s and Lowell’s times. Moreover, even if ground-based observations under best conditions based upon up-to-date technology were giving hints of structures akin to Valles Marineris, those findings would not rival the unequivocalness of observations delivered by Mariner 9 in 1972 and subsequent missions.

Manfred Cuntz
Department of Physics
University of Texas at Arlington