Do You Believe in Magic? Topol, Offit on Alternative Medicine

The Oprah Effect

Dr. Topol: Another part of the story that seems to have had a big impact in the United States is the Oprah effect of creating monsters, if you will -- although you didn't use that term, I don't think. But there are 3 physicians that she kind of brought to the floor. We are going to talk about celebrities in a minute, but Oprah brought 3 physicians to the forefront: Mehmet Oz, Andrew Weil, and Deepak Chopra. And it seems like all 3 of them, as you reviewed in your book, had a big amplification of their impact -- if not even the beginning of their stardom -- with Oprah. Do you want to comment about that?

Dr. Offit: Oprah has a tremendous stage, and she has been very good about many things -- especially, for example, getting this country to read more than they would have otherwise. She is a sympathetic figure who likes to promote people whom she views as potential victims, and in that way she has been very good.

But with regard to science and medicine, she has been pretty awful. She was on the cover of Newsweek with a picture that made her look frankly a little crazy -- and it read just that. [Editor's note: The cover story of the June 8, 2009, issue of Newsweek was "Crazy Talk: Oprah, Wacky Cures, & You."] It was sort of Oprah's crazy science. She gave birth to Jenny McCarthy in many ways and Jenny McCarthy's notions that vaccines could cause autism. And she has given birth to Deepak Chopra -- certainly launched Deepak Chopra and such people as Mehmet Oz -- and she likes at some level the guru phenomenon.

I think that is what Oz and Chopra and Weil all have in common. They sort of present this notion of medicine as a guru, sort of, "Listen to me." And medicine is not that. I mean, science is viewed by some as distant, technological, and cold. What people like Oprah, and like Oz, Chopra, and Weil, do is imbue their medicine with a kind of spirituality. It becomes a matter of them and their personality rather than the data, which is always a little dangerous.

Dr. Topol: Why do you think they are so successful? Is there just this extraordinary need to have the wise leader and the spirituality? Is there a craving for that out there? What do you think is the real underpinning?

Dr. Offit: I think that is it. I don't know if you remember the TV show Star Trek, but there was the doctor on that show -- Bones McCoy. He would take this scanning device, and he would scan up and down, look on that device, and that was the diagnosis. It was immutable. It was clear. There wasn't any question about it, and that is just not medicine.

With medicine, we certainly will know far more 100 years from now than we know now. There is much about medicine that stymies us, but that is not these guys. People like Oz and Chopra and Weil have a certain surety and immutability that I think is very attractive because the fact is that medicine does have limits, and yet that is all we have right now. They sort of go to a level beyond that, and I think that is extremely attractive.

People will say you can't trust science because, for example, one study will show one thing, and then that study will be shown to be incorrect. And you and I would argue that that is good. That means that science is self-correcting. We can take a textbook and throw it over our shoulder without a backward glance as we get more and more information, but to some people that mutability and fluidity is viewed as disconcerting. They want something that is surer, and these people provide that in their books. You look at Andrew Weil's books. He tells you how to be a friend, he tells you how to make low-fat salad dressing, he tells you how to live your life -- and that is attractive.

A Look at Fish Oil

Dr. Topol: You gave a pass to certain things in your book, which I was a little surprised about. For example, you were kind to fish oil. And you probably saw the big paper in the New England Journal of Medicine ? It was a big Italian study that showed that fish oil didn't do anything for preventing heart disease. Would you revise? Would you be a little tougher on fish oils if you were to get the most updated information, or do you still think there is a place for fish oil?

Dr. Offit: Absolutely. Harper Collins is the publisher; it is a big publisher. This book was written a year and a half ago, so it takes a while to get those books out. I absolutely would revise it, and there were some recent studies that showed that at least the antioxidant part of omega-3 fatty acids actually could increase your risk for such things as cancer, so I absolutely would revise it. That is the problem with books -- they are written at a specific point in time.

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