Each summer I spend about a month in my country of origin, Bulgaria. Much can be said about Bulgaria, but one thing has struck me time and time again: Bulgarians live in a superstitious reality with great emphasis on alternative treatments. Completely contradictory to scientific thinking and my way of perceiving the world. Below are just some of the alternative beliefs that I was told of recently and that prompted me to attack one of them in this blog post.
Example 1: the magic wand
A friend went to a special practice that offered a whole-body assessment of her health. All she had to do was to hold a metal rod that somehow managed to detect the spin of her cells’ nuclei (mind you, I studied biomedicine and I have never heard of nuclear spin except the one taught in chemistry/physics, which describes a specific quantum property of atoms, not cell nuclei). Anyway, the assessment – which only took a few minutes – produced multiple pages with detailed descriptions of the current state of each and every organ in her body. This practice had a special name, which I never really caught (my brain cell nuclei must have spun the wrong way!), but I’m certainly impressed… Hallelujah, who needs expensive hospital equipment such as CT scanners, when Harry Potter’s magic wand gives you the answer in two minutes?
Example 2: the fortune teller
It is common practice for many Bulgarians to visit a fortune teller following a traumatic experience. I have recently been reminded of this custom, one that I was often exposed to as a child. Say you experience a car crash that causes no major injuries apart from scaring the hell out of you. You must go to visit the fortune teller to externalise the fear. She (it is often an elderly woman) will cover your head with a sheet and melt a piece of lead in a spoon at the level of your heart. The sheet covering your head only allows you to discern the human silhouette and the metal spoon containing a burning peace of lead, whilst hearing the mumbling of some (to me) random words. Next, cold water is splashed onto the molten lead, upon which it solidifies to take the shape of your fear, which has now been externalised. The fortune teller, of course, doesn’t need to know your fear beforehand – the shape of the solid lead piece has got it all… No need for expensive therapies, folks.
Example 3: lucky arrangements
Some friends had adopted an ancient Chinese (or Japanese?) method of calculating how to arrange their home in a way that is most beneficial to each individual family member in terms of well-being. For example, it is absolutely crucial that your bed doesn’t face the door – crucial enough that my friend chose to sleep at a right angle to the bed’s length to avoid facing the door in her sleep. You are also worse off if your bathroom is right across your entrance because all the luck will end up in the bathroom and disappear through the drain… Well, if you happen to be unfortunate and have a home with this arrangement, fear not – just make sure to put a mirror on the bathroom door and keep the door closed. The good luck will be reflected by the mirror and avoid the drain. It’s that simple.
Example 4: homeopathy
Homeopathy. For everything. Almost every second person I have spoken to during the past two weeks relies on homeopathic “treatments” for one or several conditions. I saw friends bring a box full of more than 30 homeopathy pill flasks on holiday, I heard of others who would ship them abroad to their children, and I met a woman who even works as a “medical” representative for a German homeopathic company in Bulgaria. Homeopathy has become disturbingly popular across Bulgaria, being embraced by people from all societal classes. These individuals turn their backs to evidence-based medicine, paradoxically putting their health at risk while desperately trying to achieve the exact opposite.
My frustration with this practice has soared, and it is time for it to be released. It is time to have a look at why bringing Pandora’s homeopathy box on holiday has only one effect: taking up space and adding weight to your bags; and why substituting evidence-based medicine with unsupported homeopathic practices is a foolish decision. Arguably, there is a myriad of phenomena that science can’t explain (yet). Homeopathy, however, isn’t one of them.
A faulty concept
According to Karl Popper and his “Logic of Scientific Discovery”, a hypothesis is formulated and subjected to empirical testing, gaining strength as it withstands multiple attempts at falsification. Accordingly, it is the extent to which a system can be falsified – not verified – that is taken as a criterion for strength. A strong theory is, therefore, one that withstands multiple attempts at falsification. So my theory is that homeopathy is bollocks; nothing more than poor pseudoscience. Let’s attack this theory of mine with some common homeopathy-supporting evidence.
The core homeopathic principles are: 1) “like cures like” and 2) the smaller the dose, the better the cure. Is there any evidence that “like” may actually “cure like”? When we eat plant-based foods, we inevitably consume small amounts of toxic chemicals, which cause mild stress to our cells. A bit like exercise. This stress is good; rather than damaging the cells, it makes them stress resilient. But this is not homeopathy. This is hormesis – the notion that otherwise toxic substances are beneficial to our health when consumed in small amounts. It is distinct from homeopathy because it relies on clear biological mechanisms. Trace amounts of selenium – available in brazil nuts – are needed as this nutrient is essential to the function of key enzymes within our cells. In contrast, how a homeopathic preparation based on onion fumes can cure the runny nose and watery eyes of a cold remains a mystery.
But isn’t it similar to a vaccine, you ask? Not the least. The basis of vaccines is scientifically well-defined: the body is exposed to a safe version of a specific pathogen to prime the immune system to recognise the real version of the bug. In other words, a vaccine is preventative and disease-specific. A vaccine against smallpox whilst having full-blown smallpox is worthless. Conversely, a smallpox vaccine is ineffective against HIV. In comparison, homeopathy appears rather non-specific. Although a runny nose can have multiple causes – e.g., a cold or allergy – simply recreating the symptom should cure the condition regardless of its properties. Most people would agree that this contradicts common-sense knowledge about how the human body operates.
What about the “less is more” aspect of homeopathy? Homeopathic preparations are generally diluted extensively until there is hardly any trace left of the original substance. According to homeopaths, the water has a “memory” of the active ingredient. Well, I certainly hope it doesn’t as this would mean that the water I’m drinking at the moment may remember all the bugs and waste it contained prior to undergoing drinking water treatment, which, among other things, is done to prevent waterborne diseases from spreading. Still in doubt? You only need to watch James Randi “overdose” on homeopathic sleeping “medicine” to realise that these are nothing more than sugar-coated pills. In fact, the indefinite dilutions common to homeopathic remedies result in you having a higher chance of winning the national lottery five weeks in a row than finding a single molecule of the original ingredient.
The most faithful homeopathic proponents are still left with their strongest weapon to falsify my theory: their claims that homeopathy – regardless of the lack of a plausible mechanism to explain it – does work as evidenced by multiple cases of successful treatments of a wide range of conditions, including bronchitis, ear infection, allergies and even cancer. I decided to explore this on my own and face this weapon directly by visiting the website of the UK Society of Homeopaths http://www.homeopathy-soh.org to assess the strength of their evidence. The Research section contains information on Clinical Trials. A good clinical trial should randomly assign a participants into a placebo-treated group and a group receiving the treatment under scrutinity. The greater the number of participants, the lower the risk of spurious results just by chance. The strongest clinical trial is the randomised “double-blind” in which neither the investigator nor the participant know what treatment an individual receives. I looked into the clinical trials listed to support the effectiveness of homeopathy, and none of them were double-blind. I was even more surprised at the way some of these trials were portrayed. Thus, there is supposedly “un-refuted evidence” that homeopathy is effective against ear infection according to a clinical trial. I decided to check it out myself. I’m sorry homeopathy believers, but this is far from solid. First of all, the study relied on 75 children and the authors themselves admit that they would need a total of 486 children to obtain statistically meaningful results. They don’t observe anything that couldn’t be due to pure chance and themselves end with a somewhat skewed conclusion that “a positive treatment of homeopathy when compared with placebo in [acute ear infection] cannot be excluded and that a larger study is justified.” Translated: we found no evidence of a positive effect of homeopathy.
Others have pooled all the evidence from many trials together and found that homeopathy is no better than a placebo, attributing small-scale positive results to poor methodologies and random effects similar to the aforementioned study on acute ear infection. In fact, The National Health and Medical Research Council in Australia recently undertook and published a rigorous assessment of the evidence of effectiveness of homeopathy for treating health conditions using standardised and accepted methods for assessing the quality and reliability of the available evidence. They concluded that “there are no health conditions for which there is reliable evidence that homeopathy is effective. Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness[…]” Sadly, loss of life has already been associated with homeopathy, serving as a warning sign to patients and parents who might opt out of conventional treatment strategies.
Communication is alfa and omega
In trying to understand why such pseudoscientific concepts are gaining widespread support across the world, I arrived at the conclusion that it represents a general attempt to oppose authorities and to express mistrust. Doctors and scientist are unfortunately assigned the “authority” tag, and in today’s world this tag evokes negative connotations, including hidden information and public deception. This struck me immediately when one of my friends uttered, “You scientists are doing fancy things in a completely different reality. You probably know everything about aliens etc. that you keep secret from the public.” Others kept saying, “Authorities inflict diseases upon the public in a controlled manner only to support the sales of big pharma.”
Such statements clearly illustrate why we – scientists – have a duty to engage with the public. Coming down off our pedestals is essential to increase the public confidence in what we are doing and to promote sound, evidence-based science.