Tradition. Many alternative medicines tap into our fondness for the good old days, simpler ways of doing things, and especially the lure of ancient wisdom. But, just like the "natural" claim, old or traditional does not necessarily mean safe and effective. Bloodletting was a traditional treatment, but I wouldn't recommend giving up a few precious pints if you come down with the flu.

A study of women in Pakistan who delayed seeking treatment after being referred for care after lumps were discovered in their b.r.e.a.s.t.s found that 34 percent of these women delayed seeking proper medical treatment because they relied on traditional treatments. Of these treatments, homeopathy was most common (70 percent), followed by "spiritual therapy" (15 percent). "The delay results in significant worsening of the disease process," concluded the researchers.5 CAM kills.

A study in Africa found that a significant number of acute renal failure cases (rapid kidney failure) are caused by reliance on traditional or folk remedies. This is another example of death by alternative healthcare: "In conclusion, ARF [acute renal failure] occurring after use of folk remedies in South Africa is a.s.sociated with significant morbidity and mortality [italics added].... Significantly, although a proportion of patients have underlying systemic or renal conditions that may contribute to renal dysfunction, in the majority of patients, folk remedy use appears to be the most likely proximate cause."6 Clearly traditional medicine fails millions of people when modern, science-based medicine could have given them a better chance.

Cheapness. Not that all CAM treatments are inexpensive, but many are and this is explains some of the appeal. When a poor person is sick, an unproven $5 herbal "cure" is likely to sound a lot more attractive than a $75 visit to a doctor who may prescribe a proven $100 medication. If people were more informed and understood that wasting $5 only leaves them with the same problem they started with, they might make better choices. In many circ.u.mstances, however, people simply can't afford evidence-based medicine, or it's not available to them where they live. In these cases the particular society and the world at large have a moral issue that needs to be addressed. It's bad enough when people choose snake oil because they are not skeptical and don't think critically. It's far worse when the conditions they live in leave them no choice.

Fear factor. A huge advantage CAM has over science-based medicine is that it's not nearly as scary. If I'm sick or injured, I will choose to go with modern medical science, but there is no denying that a visit to a hospital can feel a lot like being sent to a torture chamber. In hospitals people jam needles into your skin; they suck fluids out of your body; they probe and peer into very personal places using scary metal instruments; sometimes they even cut you open and take things out of you. Yes, these procedures are great because they save lives all around the world every day. But they horrify most people who experience them, nonetheless. Now, consider what is entailed with virtually all alternative medical treatments: you pop a sugar pill, drink a shake made from some plant, or maybe just wear a magnetic bracelet. It's the path of least resistance, far more appealing and comfortable than cold surgical instruments, chemotherapy, or drugs with severe side effects. Well, more appealing right up until your untreated illness kills you, I suppose.

Safety. It may be a surprise to some, but in many cases alternative medicines really are safer and do have less side effects than science-based medicines. But the reason for this is because many alternative medicines contain no significant ingredients and don't do anything! For example, a typical homeopathic medicine truly is safe and really doesn't cause side effects. But that is only because it's water! One wonders if there is any limit to the absurdity of alternative medicine. I fully expect to see somebody selling pills filled with air one day soon. They will say the natural and safe air in the capsules is magnetized or some nonsense and claim that it cures cancer, Alzheimer's, and other diseases. And people will buy it. Wait and see.

Trust issues. A general mistrust of governments and corporations probably adds to the appeal of alternative medicine. A 2010 Gallup poll found that nearly half of Americans rate the work of pharmaceutical companies as no better than fair or poor.7 That's fertile ground for CAM to work in. Everyone knows that modern medicine in the United States is big business and treating human beings often seems like a trivial concern next to profit. The mystery for me in this is, however, why anyone who finds it difficult to trust the for-profit evidence-based medical industry would run into the open arms of the for-profit unscientific CAM industry. They're big business and they care a whole lot about profits too. Given the frauds, dubious claims, and dishonest advertising that is rampant in the alternative healthcare industry, why in the world would anyone trust them more than evidence-based healthcare?

Frustration. There simply is too much frustration with modern healthcare. Some of it is justified. Some of it is unjustified yet understandable. If someone is suffering, she wants relief and she wants it fast. Many parents of autistic children, for example, are unwilling to wait on science to catch up to their personal and immediate crisis. In 2011, as many as 75 percent of autistic children were receiving unscientific alternative treatments, most of which were obviously bogus.8 Understanding the desperate circ.u.mstances some people face, however, doesn't excuse anyone from forsaking reason.

Too many patients today feel rushed, confused about their illness and treatment, and even dehumanized by their journeys through healthcare systems. This is a serious issue with significant implications for the CAM problem. While promoting critical thinking and skepticism are important, of course, I suspect that a large part of the solution to the problem of unscientific healthcare, fraud, and medical quackery has to come from improving the overall experience of today's science-based healthcare. We are human beings, and as such we bring all kinds of fears and emotional needs with us into the doctor's office. We are not robots in need of an oil change, and the health workers who make up modern healthcare have to keep this in mind. Modern medicine can learn a thing or two from the CAM culture. Clearly alternative medicine must be providing something for all these people who keep throwing away billions of dollars and risking their health on it year after year. Maybe the modern-day shamans and snake oil salesmen simply do a better job of inspiring hope and connecting with sick people as "people" rather than something called "patients."

Effectiveness...sort of. Undoubtedly CAM maintains much of its popularity and generates most of those word-of-mouth endors.e.m.e.nts via the placebo effect and fortunate timing. It's well known that taking some form of treatment, no matter how impotent it is, often helps a significant percentage of patients even though the inert medicine could not have done anything to directly treat the ailment. One may argue that alternative medicines are worthwhile, even if most of them can do no better than placebos, because that's still better than nothing. But this is not necessarily true. A placebo might make one feel better, for example, but it's not necessarily going to help with the actual problem in every case.

No doubt fortunate timing and faulty a.n.a.lysis explains many CAM success stories too. Imagine a sick person who takes some alternative medicine and then, after a week or so, has a full recovery. Chances are the person will credit the alternative treatment even though their body probably recovered on its own naturally. CAM believers also are likely to credit alternative treatments even when they were taking science-based drugs or treatments at the same time and could not possibly know which of them was responsible for their recovery.

GIVE CREDIT WHERE CREDIT IS DUE.

Imagine if we could compile a list of every person whose life was saved over the last fifty years by vaccines, antibiotics, and other science-based healthcare. Imagine a headshot next to each name. I suspect that just one glimpse of such a ma.s.sive compilation might change the minds of many people who trust in unscientific treatments. It seems few people today appreciate the amount of suffering and shocking death rates of the past. Everyone should do a tour of the developing world for a different perspective. Those of us fortunate enough to live in the wealthier societies today are shielded from diseases in ways we take for granted. Those who sell, buy, and defend alternative medicine seem to think they have no need of science-based healthcare. I certainly harbor no such illusions. I'm a huge fan of modern medicine-primarily because it has probably saved my life at least twenty times by now. I've stayed in some hotels that were so infested with germs, plants, spores, and critters that I swear the walls and floor seemed to move. I've eaten more than my share of weird and risky meals on the road (some of them seemed to be moving as well). My coddled-American immune system has also been up close and personal with all kinds of people in all kinds of places. If not for vaccines and antibiotics it's possible, if not likely, that I would have been whacked by a germ long ago.

Several years ago my son had to be hospitalized because he became dehydrated while fighting a stomach virus. The doctor a.s.sured me that everything would turn out fine, and it did. Nonetheless, I was deeply moved by the stressful event and dedicated one of my newspaper columns to it. I described my grat.i.tude for being fortunate enough to live in a time and place that enabled me to take my sick son to a hospital that practiced medical science rather than to some hut filled with nothing more than chants, smoke, and superst.i.tion, or to a gilded temple that could offer my son nothing more than prayers and promises. I saw like never before how nice it is to have a clean, well-stocked modern hospital to turn to in a moment of crisis. Had I been less aware of the advantages of science over pseudoscience and relied on alternative medicine, or was so poor that I could not afford access to evidence-based medicine, my son might have died from that illness.

We all should give credit where it's due. Medical science is the reason many of us alive today have a fair chance of making it to see an eightieth or ninetieth birthday. Vaccines, antibiotics, X-rays, scanning technology, the double-blind method of testing drugs and treatments have extended life and reduced suffering. There was a time when forty was a very old age to be, and in some places most babies never made it to year one. Medical science changed that. What have herbal drinks, homeopathy, and touch therapy done by comparison?

While some of the reasons people are drawn to alternative medicine are understandable, to a degree, none of the reasons should be allowed to overshadow the most important point of all: an alternative medicine is called "alternative" because it has not been shown to work by the tried-and-true methods of modern science. If it had been, n.o.body would call it an alternative medicine. It would simply be called medicine.

POINTS TO REMEMBER.

Alternative medicine means unproven medicine.

"Natural" does not mean safe or effective.

Anecdotal evidence (mere stories) is not good evidence. One can find a story to support just about anything.

When struck by illness or injury, the human body is usually capable of healing itself given enough time. But people often give the credit to alternative medicines unjustly.

Many people mix science-based treatments with unscientific alternative treatments. But when their condition improves, they may give credit only to the alternative treatment.

GO DEEPER...

Books Barrett, Stephen, and William T. Jarvis, eds. The Health Robbers: A Close Look at Quackery in America. Amherst, NY: Prometheus Books, 1993.

Bausell, R. Barker. Snake Oil Science: The Truth about Complementary and Alternative Medicine. Oxford: Oxford University Press, 2009.

Singh, Simon, and Edzard Ernst. Trick or Treatment: The Undeniable Facts about Alternative Medicine. New York: W. W. Norton, 2008.

Sharpiro, Rose. Suckers: How Alternative Medicine Makes Fools of Us All. London: Harvill Secker, 2008.

Wanjek, Christopher. Bad Medicine: Misconceptions and Misuses Revealed, from Distance Healing to Vitamin O. New York: Wiley, 2002.

Other Sources Quackwatch, www.quackwatch.com.

Homeopathy is utterly impossible. Homeopathic preparations are so thoroughly diluted that they contain no significant amounts of active ingredients and thus can have no effects on the patient's body....Those who believe it works either do not understand the science, or are simply deluded.

-Dr. Kevin Smith, bioethicist1 After talking to people who sincerely believe in homeopathy, laboring through a towering stack of books on the subject, talking to pharmacists, and loitering in the isles of alternative medicine shops, I have come to the surprising conclusion that homeopathy is not all bad. There is virtually no possibility of harmful side effects, for example, much different from most science-based medicines. No one can ever overdose or become physically addicted to homeopathic medicines either. There are some real advantages to the stuff.

Unfortunately, the reason that homeopathic medicines are so safe and agreeable to the human body is the same reason they are rejected by medical science: they are mostly water and not medicine. A traditionally prepared homeopathic solution is diluted to extreme levels. So diluted, in fact, that there is usually nothing left of the original active ingredient. It's water! But this minor technical detail doesn't stop the homeopathic medicine industry from selling cures for just about everything to millions of people. According to information posted on the website of one prominent homeopath and author, homeopathy can treat trauma, sprains, cuts, bruises, burns, acute pain, headaches, colds, influenza, ear pain, inflammation, chronic pain, joint disorders, chronic fatigue, migraines, stomach disorders, insomnia, frequent urination, eczema, psoriasis, PMS, menopause, post-partum depression, hormonal mood swings, hot flashes, memory loss, hormonal headaches, hypo-and hyperthyroid complaints, adrenal fatigue, depression, anxiety, phobia, grief, Attention Deficit Disorder, eating disorders, immune system problems, "and much more."

Wow, an impressive list, to say the least. Doesn't this sound like the perfect medicine, far better than the expensive and often-dangerous stuff doctors and pharmaceutical companies keep pushing on us? Homeopathic medicine can treat virtually everything and has no downside-unless we run out of water, of course. Many celebrities, from movie stars to Prince Charles, swear by the stuff, and it's sold over the counter in major pharmacy chains. So where do these wonder drugs come from and how are they supposed to work?

LESS IS MORE.

Homeopathy traces its origin to the late eighteenth century, when a German doctor named Samuel Hahnemann came up with the strange idea that using a substance that caused symptoms similar to the symptoms of a particular disease would cure the disease. This is the "like cures like" claim of homeopathy. This may hint at the way vaccines work, but it shouldn't because it's not the way vaccines work. Of course, Hahnemann knew better than to load up patients who are nauseous and feverish with something that causes vomiting and fever. His solution was to dilute the "medicine" so that it would only be enough to stimulate the body's natural defense mechanisms into action to deal with the disease. But "dilute" is an understatement. This is where it gets really weird.

Homeopathic medicine is diluted to mind-boggling extremes. In fact, solutions are usually diluted to a point where there is none of the original ingredient left in the remedies-not even a single molecule! But this doesn't make the medicine weaker or less effective, say believers. In some sort of upside-down, mirror-universe logic, homeopaths claim that their medicines get more potent the more they are diluted. So a homeopathic solution that is pure water would be immensely more powerful than one that contains 50 percent, 10 percent, or 1 percent of an active ingredient. Of course this doesn't seem to make sense. How can a medicine work if there is no medicine in it?

According to homeopaths, it works because water can "remember" the molecules it comes into contact with. I'm sure this sounds incredible to readers who are unfamiliar with homeopathic medicine and always a.s.sumed that it was simply some kind of "natural" medicine, not fundamentally different from herbal concoctions. But it's true; homeopathy defenders actually say this and seem to believe it. Pract.i.tioners and proponents claim that the water somehow retains an imprint of the active ingredient when the homeopath preparing the solution bangs the container a certain number of times. So even though no molecules of the supposed "medicinal" substance (which was itself unscientific in the first place) are likely to remain, the solution is supposed to work anyway. One skeptic estimates that a person would have to drink twenty-five metric tons of a typical homeopathic solution in order to have even a remote chance of swallowing just one molecule of the original substance.2 Dr. Ben Goldacre, another critic of homeopathy, calculates that many of these popular potions are almost incomprehensibly weak: "At a homeopathic dilution of 200C (you can buy much higher dilutions from any homeopathic supplier) the treating substance is diluted more than the total number of atoms in the universe, and by an enormously large margin. To look at it another way, the universe contains about 3X1080 cubic meters of storage s.p.a.ce (ideal for starting a family); if it were filled with water and one molecule of active ingredient, this would make for a rather paltry 55C dilution."3 This claim of water memory is extraordinary. So how do homeopaths know that water can do this? Hahnemann may have imagined or guessed it somehow, but he certainly didn't "know" it in any scientific sense back in the eighteenth century. Obvious questions are, How does water know to remember what the homeopath wants it to remember but not remember all the other stuff that has been in contact with it? (A horrifying thought, considering the places water has been! What if it remembers the bus station toilet bowl it was in last month?) And have scientists confirmed this claim since Hahnemann came up with it? Of course not. Homeopaths say that water remembers the desired active ingredient because it is shaken vigorously during the dilution process and this creates the imprint. To date there is no credible science that has proved this claim. I'm willing to concede that it's possible, only because things get so weird at the atomic level that nothing would surprise me. Read up on entanglement and you will understand what I mean. But wild possibilities are never reason to believe wild claims that are not supported by evidence.

In fairness, many mainstream medical treatments in the 1700s and 1800s were brutal, dangerous, and often ineffective. Just as many mainstream treatments today will be viewed in the future, no doubt. Many patients died not from their illnesses and injuries but from treatments administered by doctors. In many cases patients probably would have been better off doing nothing or taking a water/homeopathic treatment than facing the wrath of their time period's medical care. Fortunately for us, however, medical science has come a long way since Dr. Hahnemann's time. The scientific method, double-blind tests, and a willingness to change by accepting things that work while rejecting things that don't have given us treatments that are effective and save millions of lives every year. Evidence-based medicine is far from perfect at this time, but it performs measurably better than anything else by far.

Two things should give one reason to pause before spending any money on homeopathy or trusting one's health to it: (1) No one has been able to prove that it works even though it's been around since the late eighteenth century, and (2) it can't work, at least not according to the official laws of physics and the unofficial rules of common sense. But people do believe, nonetheless. Homeopathy is a ma.s.sive industry in India, for example, where there are more than three hundred thousand "qualified homeopaths" and three hundred homeopathic hospitals! More than half of the people in Belgium buy the stuff and 36 percent of the French population are users. In the United States, homeopathic medicine almost died out early in the last century but has roared back bigger than ever in recent decades to earn big profits. Today it rakes in more than one billion dollars per year.4 This impressive popularity is maintained despite wide condemnation from scientists and doctors in many countries. In 2010 the British Medical a.s.sociation, for example, called homeopathy "witchcraft" and voted overwhelmingly to ban the practice, as well as to stop placing trainee doctors into any programs that promote homeopathy.5 As understanding as I am about how well-meaning people come to sincerely believe in paranormal and pseudoscientific claims, I confess to having very negative feelings about homeopathic medicine. The claim is fraudulent in the way its proponents usually portray it as scientific even though it stands in opposition to science and they have failed to demonstrate that it can do the things it is supposed to be able to do. I have more respect for witch doctors because they are far more honest about what they are selling. Some argue that homeopathy is a safe alternative to science-based treatments and if it gives some people satisfaction, what's the harm? The harm is that it puts people at risk by misleading them into trusting a vial of expensive water or a sugar pill over real doctors and real treatments. Anyone who cares about the health and safety of others has a moral obligation to oppose homeopathic medicine.

I asked a senior pharmacist at a CVS drugstore in southern California how she felt about homeopathic medicines being sold over the counter not more than twenty feet from the pharmacy counter she worked at. I suggested that the juxtaposition of science and pseudoscience was improper and that selling homeopathic treatments in this context suggested that it was legitimate medicine. It's presence next to a pharmacy counter likely gives it unjustified credibility in the minds of many customers. I pointed out the odd contrast of her having worked to earn professional qualifications as a pharmacist in order to distribute the best help medical science can offer to people in need, while a few steps away magic water was being touted for the treatment of everything from anxiety and asthma to vertigo and warts. It would be no less incongruent and improper if somewhere in the National Academy of Sciences Building there were an office dedicated to tarot card reading. She replied that she only works in the pharmacy and has no control over what is sold in the store. "But does it bother you?" I asked.

"Yes, I understand what you are saying," she said. "But what can I do?" She seemed to acknowledge that it was a waste of money and her facial expressions suggested that she agreed the stuff had no business being in a respectable drugstore. However, "it's not my department" was the best she could come up with.

HOMEOPATHY FAILS IN THE UK, TOO.

Homeopathic medicine is even more popular in the United Kingdom than in the United States. A House of Commons Science and Technology Committee conducted an in-depth inquiry in 2009 and 2010 and came to the conclusion that homeopathy is unproven, unscientific, unlikely to work better than placebos, and unworthy of government funding or endors.e.m.e.nt. Some highlights from the official report of the proceedings: We [House of Commons Science and Technology Committee] consider the notion that ultra-dilutions can maintain an imprint of substances previously dissolved in them to be scientifically implausible.

In our view, the systematic reviews and meta-a.n.a.lyses conclusively demonstrate that homeopathic products perform no better than placebos.

To maintain patient trust, choice, and safety, the Government should not endorse the use of placebo treatments, including homeopathy.

We conclude that the principle of like-cures-like is theoretically weak. It fails to provide a credible physiological mode of action for homeopathic products. We note that this is the settled view of medical science.

We do not doubt that homeopathy makes some patients feel better. However, patient satisfaction can occur through a placebo effect alone and therefore does not prove the efficacy of homeopathic interventions.

There has been enough testing of homeopathy and plenty of evidence showing that it is not efficacious. Compet.i.tion for research funding is fierce and we cannot see how further research on the efficacy of homeopathy is justified in the face of competing priorities.

Professor David Colquhoun, professor of pharmacology at University College London: "If homeopathy worked the whole of chemistry and physics would have to be overturned."

(Source: House of Commons Science and Technology Committee, Evidence Check 2, www.publications.parliament.uk/pa/cm200910/cmselect/cmsctech/45/45.pdf) If I were a pharmacist in this situation, I would attempt to unite with my colleagues and send a strongly worded message to company headquarters requesting/demanding that they stop selling bogus medicines to people, many of whom are seeking treatment for serious health problems. Yes, the aisles near the pharmacy counter are technically a different domain, but I don't think that is how it is perceived by many people. To many customers, that general area of the store is "the pharmacy" and pharmacists often blur the line further by coming out from behind their counter to a.s.sist and answer questions about products found on the shelves. Maybe if indifferent medical professionals paused and actually thought about the real harm trusting in homeopathic claims over evidence-based medicine can cause, they might take it more seriously.

DEATH BY HOMEOPATHY?.

Consider the case of Gloria Mary Sam, a baby who died in 2002 in Australia of septicemia (blood infection) after eczema ravaged her tiny body for months. Gloria's parents-both college educated-were convicted of manslaughter because they refused to seek medical treatment for the suffering child. They received repeated advice to seek proper care for her from science-based medical professionals but did not. Why not? The reason was that the father, Thomas Sam, a "practicing homeopath," was confident that his child did not need any treatment other than homeopathic concoctions. The Sydney Morning Herald reported on the trial: They [parents] watched her skin bleed, her hair go white and her small frame shrink as their baby girl fought to battle her eczema. They watched her constantly scream out in pain, her sores weeping through tears in her skin, and the corneas in her eyes melt. And in the end, by not seeking proper medical treatment until it was too late, a homeopath and his wife watched nine-month-old Gloria Mary die.6 Don't think for a second that this was some bizarre once-in-a-million-years case. There are too many examples of homeopathy distracting from, hindering, or blocking medical science to the detriment of someone's health. In Ireland, Mineke Kamper, another homeopath, was allegedly linked to the deaths of two of his patients. He reportedly told one to stop taking her asthma medication and she promptly died of an asthma attack in 2001. Kamper also used homeopathic medicines to treat another patient who had a treatable (with medical science) cancerous tumor. That patient died in 2003.7 Russel Jenkins, fifty-two, stepped on an electrical plug at home in 2006, cutting his foot. When the wound failed to heal, he sought treatment from a homeopath and later died from complications. A vascular surgeon said Jenkins would have had a 30 percent chance of survival if he had sought proper medical treatment even just two hours before he died. His mother was devastated: "To lose my son is devastating, absolutely. But the way he died. I just can't come to terms with it when I know all it needed was a phone call for a doctor or ambulance, for antibiotics and my son would be here today."8 In 2009, a baby died in j.a.pan from a subdural hematoma due to vitamin K deficiency. The mother sued the midwife who had been caring for the baby because the midwife allegedly had taken it upon herself to give the baby a homeopathic supplement rather than the vitamin K supplement she was supposed to administer.9 In the United Kingdom, homeopaths have drawn fire from the medical community for recommending their water over conventional antimalarial treatments. "We've certainly had patients admitted to our unit with falc.i.p.arum, the malignant form of malaria, who have been taking homeopathic remedies-and without a doubt the fact that they were taking them and not effective drugs was the reason they had malaria.... [T]hey could die," said Dr. Ron Behrens, director of a travel clinic at the London Hospital for Tropical Diseases.10 Medical science has come far in recent centuries. The human life span has been extended significantly as a direct result of science-based healthcare. Magic water may seem appealing at first glance. Look more closely, however, and it becomes clear that it's a waste of time and money. Yes, modern medicine is imperfect, but for those who value proven results it's the only game in town.

GO DEEPER...

Ernst, Edzard. Healing, Hype, or Harm? A Critical a.n.a.lysis of Complementary or Alternative Medicine. London: Imprint Academic, 2008.

Goldacre, Ben. Bad Science: Quacks, Hacks, and Big Pharma Flacks. New York: Faber and Faber, 2010.

One of the saddest lessons of history is this: if we've been bamboozled long enough, we tend to reject any evidence of the bamboozle. We're no longer interested in finding out the truth. The bamboozle has captured us. It's simply too painful to acknowledge, even to ourselves, that we've been taken. Once you give a charlatan power over you, you almost never get it back.

-Carl Sagan The best thing about being a writer is that you have a good excuse to place yourself in unusual places with interesting people. Tonight I'm a mere twenty feet away from Benny Hinn, perhaps the most popular faith healer in the world today. I'm surrounded by thousands of his devoted fans in an open-air football stadium. They have come expecting this little man with a big stage presence to call down miracles from heaven, and he's about to deliver.

Hinn stalks from one side of the stage to the other. The white suit and white shoes glow against the black night sky behind him. Hinn's over-engineered hair never falters in the strong breeze. He closes his eyes tightly and begins to sing: "Hallelujah...Hallelujah...Hallelujah...Hallelujah..."

The slow, one-word song is remarkably dramatic. Each word seems to penetrate the believers who begin praying, mumbling, chanting, and screaming. Many reach up to the sky, some flail at it almost as if trying to claw their way up to heaven. Hinn continues the slow-paced one-word song: "Hallelujah...Hallelujah...Hallelujah...Hallelujah..."

The effect is stunning. It feels hypnotic-maybe it is. Some of the people in the audience begin to twitch. One woman falls to her knees and begins to convulse as if she is receiving jolts of electricity. Although I'm a skeptic filled with doubt about Hinn's ability to provide or facilitate supernatural cures, I can't deny the impressive emotional power of his presentation. It's a potent psychological c.o.c.ktail of music, religious belief, and hope. It's not difficult to understand how people are swept up in the excitement of Hinn's performances.

Suddenly Hinn freezes on stage and whispers into the microphone: "The Holy Spirit is with us now. It's time to claim your healing." Random shrieks rise and fall in the audience. Several believers "speak in tongues," the incomprehensible "language" some say G.o.d inspires them to speak. Suddenly Hinn screams: "G.o.d heals today!" His eyes close tight and he extends an open hand toward the audience. "Some will feel electricity. Some will feel heat all over their body. Some will feel vibrations. Take your healing now."

This seems to me like a clear case of the "power of suggestion" in action. Hinn wants the evening to go a certain way, so he tells his primed and willing audience precisely what they are supposed to experience. And they do as they are told, so far as I can tell. An interesting aspect of a Benny Hinn faith-healing event is that the "healings" take place at this point, not later when believers are sent up on stage to be touched by Hinn. According to Hinn, G.o.d actually heals people while they are still in their seats. They only come up on stage in order to get some sort of final dose of the Holy Spirit. Most outside observers, I would think, miss this important distinction. On his television show, for example, it is presented as if the healing happens on stage when Hinn touches people. Of course this works well for Hinn because it allows him to describe himself as little more than a humble master of ceremony, while at the same time everyone sees people collapsing and writhing on stage after his "anointed touch" which suggests that he has great healing powers.

For those who have never seen Hinn's "touch" in action on his television show or clips on YouTube, it's a sight to behold. It shouldn't surprise anyone that his ministry rakes in many millions of dollars per year because he really does put on an unforgettable show. After the "healing" by G.o.d takes place, Hinn calls for those who were healed to come forward to possibly appear on stage. This is key to the process because those who come forward are self-selected believers who are already at a high level of excitement and satisfaction because they think they have just been healed. This virtually guarantees that Hinn won't get any duds on stage. As people arrive at the side of the stage, Hinn's workers conduct quick interviews to determine who gets on stage with Hinn and who doesn't.

The crowd's excitement peaks when people are sent out to be touched. Hinn asks most of them what G.o.d has healed them of. On this night a wide variety of ailments were wiped away, including AIDS, cancer, arthritis, diabetes, chronic eczema, and one heart problem. The workers feed believers to Hinn rapid-fire from both sides of the stage alternatively. They do this at high speed, as if there is some time limit or deadline to meet. The frantic pace adds to the excitement. A woman tells Hinn she has been addicted to drugs for many years. Hinn touches her face. Immediately she shakes violently and collapses into the arms of one of the "body catchers" who stand behind the believers. "She has been freed of the addiction demon!" declares Hinn. The crowd explodes with cheers. It's odd that the woman would have such a dramatic reaction to Hinn's touch because the supposed actual cure from addiction already took place fifteen or twenty minutes ago. It's also interesting to note that anyone who displays an above-average physical reaction to Hinn's touch is immediately lifted back up on their feet so that the preacher can knock them down again with his powers-or, technically, G.o.d's power that travels through Hinn's fingers. The audience goes wild over these double and triple doses of the "Holy Spirit."

Amid the falling bodies and frenzied crowd's screams, Hinn repeatedly states that he is not doing the healing, that it's all G.o.d. Of course, this does little to diminish the obvious image being sold here, that, no matter what he says, Hinn is very special. I don't know about you, but when I touch people they don't go into convulsions, faint, and become twitchers on the ground. But I'm sure this professed deflection of credit and humility plays well with the audience who might otherwise suspect that he is a little too G.o.dlike for their tastes. "I have nothing to do with this," says Hinn. "I am even more amazed than you are." Then he promptly returns to dropping people on stage with his fingers. Sometimes he knocks believers down with a mere wave of his hand from several feet away.

I carefully observed Benny Hinn in action and saw nothing to suggest that he might really be a conduit to a G.o.d or otherwise possess magical healing powers. Everything I witnessed can be explained as nothing more than the expected behavior of people who were predisposed to play along with a carefully ch.o.r.eographed performance that has all the tried-and-true elements of faith healing that have been in practice since the first prehistoric shaman hung out a shingle. Hinn is very good at what he does and he is able to tap a deep well of religious pa.s.sion and conviction that is thousands of years old. The audience was a self-selected group who wanted to see Hinn. Then a small subset of that crowd was selected for the onstage antics. They came with expectations and Hinn was smart enough to cater to those expectations precisely. Did anyone get healed of a serious medical condition? Of course not, and I suspect Hinn knows this. If he (working as G.o.d's humble middleman) really did have a hand in curing people of AIDS, cancer, arthritis, and diabetes that night he would have demanded, and deserved, front-page coverage in the New York Times the next morning. He also would have clinched the n.o.bel Prize in Medicine.

With such an ability to heal, Hinn no doubt would feel morally obligated to visit hospitals day and night. I hear they have lots of sick people in need of healing in those places. Faith healers often say or suggest-cruelly, in my opinion-that if a healing doesn't occur, it is the fault of the sick person because she or he lacks sufficient faith. I heard Hinn say more than once that one's faith is the key to successful healings. But if Hinn is worried about wasting his gift on the undeserving, there's an easy way around the problem. He can simply share his anointed touch with the more than twenty-five thousand babies who die in extreme poverty every day in the developing world. If his supernatural delivery system of divine healing can overcome AIDS and cancer, then malnutrition and dysentery should be easy. Surely neither G.o.d nor any preacher would begrudge lifesaving healing from a one-or two-year-old baby for lack of faith, right? But no, Benny Hinn seems to prefer to hop from stadium to stadium where he is greeted by thousands of preconditioned believers who know the routine-and have money to give.

So what is the reality behind this popular claim? Can prayers or the touch of some special holy person actually heal? Yes and no. There may be some positive benefit experienced by some people as a result of faith-healing efforts. But there is no reason to jump to the conclusion that a G.o.d or supernatural forces are the reasons. It can more sensibly be explained as the placebo effect or the excitement that makes people feel better temporarily. Sometimes it is likely a coincidence that people get better soon after they partic.i.p.ated in a faith-healing event. Remember, we all recover from the majority of injuries and illnesses we get in our lives-whether or not a preacher touched us. The placebo effect still is not fully understood, but some people do improve simply because they believe that they are receiving treatment for their problem even though they are not. It's worth noting, however, that the placebo effect does not restore missing limbs or instantly close wounds. It is remarkably similar to faith healing in this regard. By the way, why don't G.o.ds and professional faith healers heal amputees, anyway? It's a fair question, especially given the many thousands of children who have lost limbs in car accidents or by stepping on landmines. There is even a website dedicated to this mystery.1 No, faith healing only seems to work on internal problems we can't easily see or types of illnesses that often heal independently with or without faith healing.

Faith healing almost certainly does not work the way millions of people believe it does. If prayers and faith healers had really been curing serious health problems for thousands of years, we would be certain of it beyond all doubt by now. It should be simple to measure: Are those people who are touched by faith healers in these ritualized events healthier and do they live longer lives than those who are not? To date, no one has ever been able to prove it.

Keep in mind when thinking about faith healing that it's nothing new. Faith healing has been around at least since the Stone Age. The only significant differences between Benny Hinn and a Paleolithic shaman are clothing allowance and a television show. Faith healing is a claim we can confidently reject as almost certainly not valid because it is so audacious in its claims and so utterly lacking in proof. If one healer, one specific type of prayer, or one religion really and truly healed people as dramatically and consistently as preachers like Hinn claim, then humankind certainly would have noticed it by now and all seven billions of us would have rushed to it. We don't see millions of desperately ill Muslims, Hindus, Buddhists, and animists flocking to Christianity because Christian faith healers claim they can cure cancer, AIDS, and other serious illnesses. And we don't see Christians and Jews with cancer running to animism or Islam because of the long traditions of supernatural healing a.s.sociated with those belief systems. As with many other unproven beliefs, proponents of faith healing have unjustified confidence in their claims because they ignore the equally pa.s.sionate and sincere claims of people in contradictory belief systems.

In addition to the big Benny Hinn production, I also attended two small faith-healing services. One starred a woman who said she met Jesus, who gave her special powers and sent her on a mission to heal people. She "laid hands" on many people that night, including a very sickly old woman whom she declared to be healed. I photographed this and wrote an article about it for the newspaper I worked for at the time.2 I learned that the old woman died a week later, but I was instructed by my boss at the newspaper not to do a follow-up story.

Another healing event I attended was by far the worst. After a lengthy sermon that was nothing but a series of the most shallow cliches imaginable punctuated by random Bible quotes, the preacher called for anyone to come forward who was suffering back pain. A few people raised their hands, and the preacher chose one. The man walked to the front of the church without limping and he did not show any signs of being in pain. The preacher promptly sat him down and declared to the rest of us that the man's back hurt because he had one leg that was shorter than the other. It just so happens that I had read about this common scam. I was shocked because I was under the impression that it was outdated and n.o.body used it anymore. Apparently they do, however, as the preacher lifted the sitting man's feet, shook them and then either aligned them in a way that made his legs appear uneven by about an inch or two or pulled one shoe off just enough to make the feet misalign. This is not difficult to do, no matter how long or short the legs are. The audience was invited to come up close and inspect the asymmetrical legs. The preacher then shook them and realigned them again so they were even. I couldn't believe what I was seeing. It was so transparent and embarra.s.singly bush league. This guy was no Benny Hinn. But, to his credit, he pulled it off. The audience oohed and awed as if they had just seen Lazarus raised from the dead. That experience made me wonder just how bad a faith healer has to be before people refuse to believe. But it turns out that the most enlightening faith-healing session I would ever witness would be the one in which I was the one getting healed.

THEIR PRAYERS LIFTED ME OFF THE PAVEMENT.

Cruising fast through the streets of the Cayman Islands on my bicycle, I had a Bob Marley tune playing in my ears and no worries on my mind. Without warning, however, a careless driver pulled out of a parking lot and we collided. I don't remember the launch or the landing, but I do recall the flight. It may be my edited and embellished memory speaking, but I really do remember feeling like a superhero as I soared over the hood of the car. I managed to plant a hand on the hood, which stabilized my flight just enough to allow me to execute a fast one-handed cartwheel. It was a smooth move, to say the least. An Olympic gymnast would have been impressed. I only had to flip my body around, stick the landing on the other side of the car, and take a bow. Unfortunately, my moment of supreme physical grace degenerated into the dorkiest belly flop in recorded history. My feet had rotated too far under me during the cartwheel, and I crash-landed hard. To this day I cringe thinking about it.

After a brief nap on the warm asphalt, I looked up through a haze to find several very large Jamaican women hovering above me. They circled around like a tight formation of Zeppelins, blacking out the stars like an eclipse. And then it got weird. They began shouting: "Lord, heal dis boy!"

"Come Jesus and help 'im now, please."

"In Jesus name we pray!"

Apparently the women had rushed over from their evening service at a tiny church across the street and were eager to practice what they had just heard preached. Still flat on my back, bruised and bleeding, I began to feel special. Everybody likes to feel loved. Even though they didn't know me, these kind women came to my rescue. They even brought a G.o.d with them to help. I was flattered.

As they continued to pray for my divine healing with increasing pa.s.sion and volume, I became highly motivated to get up on my feet and rea.s.sure them that I was going to be OK. So I did. I hopped up, dusted myself off and thanked them for their concern. I didn't realize it until later, but this gave me deeper insight into the way many people likely feel when they stand before Benny Hinn or some other faith healer. People aren't stupid; they know how the script is supposed to go. Who wants to be the party p.o.o.per, the creep who disappoints everybody by not getting healed? This becomes especially powerful if a preacher ties one's level of conviction to the success of the healing. It puts the blame on the person rather than the G.o.d. I am sure that this "pressure to perform" plays a big role in faith healing. I'm not suggesting that everyone who takes part in a faith-healing session is faking, but the urge to go along and not let people down is powerful. I know because I felt it that night in the Cayman Islands. There is also the inevitable adrenaline surge most people will get in such a situation. That alone can be enough to make a bad back feel better momentarily, for example. I recall interviewing a World War II P51 Mustang ace who told me that adrenaline in combat could always be counted on to make any pain or discomfort vanish-at least for a while. In short, until someone can prove that faith healing works, it makes no sense to believe it does because there are many simple explanations for what is really going on. Unlike some other irrational beliefs that might only waste time and money, this one is a clear danger to people. Sure, it may offer comfort, maybe even temporary relief, to some who believe in it. But is it worth the risk? Terence Hines, a professor of neuroscience, offers a stern wakeup call for anyone who may think faith healing is harmless: One point about faith healers cannot be overemphasized: They kill people. Convinced that they are cured when they are not, they may be dissuaded from seeking legitimate medical help that could save their lives. For example, many kinds of cancer are now treatable, if treatment begins early enough.... How many of the largely elderly and poor members of [a typical faith healer's] audience go home to great pain and even die because they have thrown away the medicine that was really treating their health problems?...In many states, laws covering child abuse and neglect contain specific religious exemptions. These permit a parent to withhold medical treatment from a child if the parent is a member of a religious group that believes in the power of faith healing or in the power of prayer to heal. Such exemptions have resulted in the death of many children whose lives could have been saved by legitimate medical treatment.3 GO DEEPER...

Brenneman, Richard J. Deadly Blessings: Faith Healing on Trial. Amherst, NY: Prometheus Books, 1990.

Randi, James. The Faith Healers. Amherst, NY: Prometheus Books, 1989.

Sloan, Richard P. Blind Faith: The Unholy Alliance of Religion and Medicine. New York: St. Martin's Griffin, 2008.

How accurate can "race" be in determining genetic links to disease and health conditions when the definition of race is one that eludes most researchers?

-From the report Geneticizing Disease: Implications for Racial Health Disparities In 1998, the American Anthropological a.s.sociation (AAA) issued a formal statement on the concept of race. It opens with these words: In the United States both scholars and the general public have been conditioned to viewing human races as natural and separate divisions within the human species based on visible physical differences. With the vast expansion of scientific knowledge in this century, however, it has become clear that human populations are not unambiguous, clearly demarcated, biologically distinct groups.1 The AAA's statement goes on to explain that there is more diversity within racial groups than there is between them. It also points out that humans have mated whenever and wherever they came into contact throughout prehistory and history and that this "continued sharing of genetic materials has maintained all of humankind as a single species." The AAA communicated it loud and clear: Traditional racial groups such as "black" and "white" are not natural or consistent biological categories. Races are cultural categories of our own design. We invented divisions between people and then proceeded to blame nature for it. While the AAA's important statement is direct and readily available to anyone, there is a significant problem with it: Virtually no one read it. Including, it seems, many medical doctors and drug company executives, because currently there are hundreds of race-based drugs in development at major pharmaceutical companies. Many scientists warn that this is a mistake that could have severe consequences for patients.

What's wrong with racialized healthcare? The more personal and precisely targeted a drug is, the better it should work, proponents say. So why not race-based medicine? It seems logical that a drug engineered for black people would work better for a black person, for example, than a drug designed for anyone and everyone, right?

No. Drugs designed and prescribed according to race are not a good idea. It's a terrible idea for the simple reason that race groups are nowhere near the biologically distinct and unique subsets of humanity that most people think they are. The last thing you want is to be prescribed a drug based on some doctor's spontaneous a.s.sumptions about your current genetic makeup and your ancestry stretching back several thousand years, all based on how you look or identify yourself culturally. No one can glance at another human being and know such things with certainty. Consider Barack Obama; he self-identifies as "black" or "African American" and, based on his appearance, people who have been encultured to think in line with traditional American race rules would identify him as such. Imagine, however, if he was not the president of the United States and instead was some relatively unknown lawyer. What would a doctor probably a.s.sume his race to be? "Black" or "African American," most likely. While this may be culturally accurate, it would be far off the mark biologically. And if Obama took a drug specifically designed and tested for African Americans-who knows?-it could be ineffective or even harmful to him. The reason Obama's genome would likely be significantly different from most African Americans is because they derive their recent African ancestry from West Africa. Obama's recent African ancestry comes from his father, who was an East African Kenyan. Ironically, it is his recent African ancestry that puts the most genetic distance between Obama and most other African Americans. His "white" mother is likely the closest kinship tie that he shares with African Americans because that population has high levels of recent white European ancestry too. The reason for this is because East Africans and West Africans are not nearly as closely related as many people a.s.sume.

Africa is our oldest home, "the cradle of humanity," and our species has lived there longer than anywhere else. This is why Africans today are the most genetically diverse population. It's also why thinking of all dark-skinned Africans as simply "black people" that fit within a single biological race is nonsense scientifically-and risky when it comes to medicine. Obama may have skin color that is similar to many other African Americans, but this does not justify lumping him in with them when it comes to the serious business of prescribing drugs that were designed based on genetic and ancestral factors. The same applies to all of us. No doctor can know the complexities of your genome and ancestry stretching back across thousands of years by simply looking at you or noting which box you checked on a form.

In my experience discussing the concept of race in a formal setting or casual conversation, the question of "racial diseases" comes up virtually every time. It seems that most people are under the impression that many diseases afflict one race and not others and that this proves both the existence of races as well as the need for racialized medicine. The reality, however, is that commonly cited examples such as sickle-cell disease as a "black person's disease" and Tay-Sachs as a "Jewish disease" are not proof of anything. Sickle-cell disease is not a "black disease." Many black people are in no danger of it and many non-black people are in danger of it. Sickle-cell trait is the result of people in some regions undergoing evolutionary adaptations in the presence of the malarial protozoa over thousands of years. It has nothing to do with our illogical concept of race. "Sickle-cell is a disease of populations originating from areas with a high incidence of malaria," states race researcher Kenan Malik. "Some of these populations are black, some are not. The sickle-cell gene is found in equatorial Africa, parts of southern Europe, southern Turkey, parts of the Middle East, and much of central India. Most people, however, only know that African Americans suffer disproportionately from the trait. And, given popular ideas about race, they automatically a.s.sume that what applies to black Americans also applies to all blacks and only to blacks. It is the social imagination, not the biological reality, of race that turns sicklecell into a black disease."2 Sickle-cell disease is a problem for many Hispanic people, people in northwest India and people throughout the Mediterranean region, many of whom have light-colored skin. "The label 'black disease,' however, rendered the distribution of sickle cell anemia invisible in other populations, leading to erroneous understanding of the geographical distribution of the underlying genetic variants," writes Charles N. Rotimi in Nature Genetics. "This is one reason why many people, including physicians, are unaware that the town of Orchomenos in central Greece has a rate of sickle-cell anemia that is twice that of African Americans and that black South Africans do not carry the sickle-cell trait."3 Similarly, Tay-Sachs should not be thought of as a "Jewish disease" because it is also a problem for non-Jewish French Canadians. False perception often trumps reality when it comes to race, and this is a mistake no one should be willing to tolerate in healthcare.

"We know race is a terrible proxy for genotype," explains biological anthropologist Jonathan Marks. "The most relevant examples would be something like a drug working in 75 percent of Africans but 25 percent of Asians. First, within each category, there will have to be huge variation, patterned the way we know human diversity is patterned: the African Ethiopians are more likely to cl.u.s.ter with the Asian Pakistanis than with the African Ghanaians. So the continental average value is hardly of use. More importantly, the drug won't work in 25 percent of Africans-and might sicken them-and will work in 25 percent of Asians [who won't receive its benefits because it won't be given to them]. What I'm getting at is that the test has to be made at the individual genotype level; prescribing a drug based on the census category of the patient is a medically very bad idea."4 Dr. Marks is correct, of course. Races as biological categories of humans are far too illogical, inconsistent, and untrustworthy to base things as important as medical diagnoses and treatments on. I certainly don't want a doctor looking at me, seeing a "white man," and making her decisions accordingly. My personal history could be a lot more complicated than that. Like it is for most people, my family history blurs after only a few generations and becomes a total mystery after six or seven. If I have no idea who the majority of my ancestors are, I know my doctor doesn't. What we need is not racialized medicine but individualized medicine. Fortunately, it's on the way. In 2003, the US government produced a rough draft of a human genome for about $2.7 billion (1991 dollars).5 By 2010, a genome could be sequenced for a few thousand dollars (though most companies charge a lot more to do it). Soon, experts predict, the cost will be less than $1,000.6 That's great; in the meantime, however, be weary if offered medical treatment that is based on race. Ask to be viewed by your doctor as a unique individual with an ambiguous ancestry spanning many thousands of years-because that is precisely who you are.

It is important to understand that rejecting the existence of biological race categories and criticizing racialized medicine does not mean that race has no place in discussions about health and healthcare. Cultural race groups are real and meaningful because we made them so. They can have deadly biological consequences and therefore can't be ignored. "Black" or "Native American" may be nonsense as biological categories, for example, but they still have to be considered because membership to a group can sometimes have very serious health consequences. This is because people often are treated differently, make unique choices, or experience different environmental conditions (stress, toxins, nutrition, violence, and so on) as a direct result of belonging to a particular cultural race group. This can cause confusion on the issue of race for the general public and many doctors because racial health disparities do exist within some societies. This leads some people to conclude that biological race is the cause, when in reality cultural race is to blame. The Pima Indians are a good example of this.

Nearly half of the adult Pima Indians in Arizona have type 2 diabetes, one of the highest rates in the world. No doubt it would be automatic for many people to see this as a biological race problem in need of a biological race solution, perhaps a race-based drug. But hold on, there is a community of Pima Indians just across the border in Mexico, and they have a type 2 diabetes rate of approximately 7 percent.7 This is essentially one population of people, with the same ancestry, split into two by an imaginary line. If race is all about kinship and ancestry, then it makes no sense that this could be a racial problem in need of a racial solution. Clearly there is something about living conditions on one side of the border (diet perhaps?) that created this health disparity. The Pima Indians in Arizona don't need a new pill designed and marketed for their "biological race." What they need to do is address whatever it is within their specific culture or environment that is causing the high diabetes rate.

Another example of a health problem that can be misinterpreted easily is the relatively low birthweight of black babies born in the United States compared with white babies born in the United States. Low birthweight is a serious matter, as it corresponds with many health risks for infants. But where many might reflexively imagine a biological race problem in need of a race-based cure, a long-term study of the problem points directly to social causes. Researchers found that black African women who had immigrated to America had babies that were the same weight as white American babies. But the daughters of these African women who grew up in America later had babies that weighed, on average, half a pound less than white babies. Furthermore, the researchers discovered that infants born to black Caribbean women who had immigrated to America weighed more than the babies of black women who had been born in the United States. If this problem were tied to biological race, then it would not spare black women from Africa and the Caribbean. It seems clear that there is something about living your entire life as a black woman in America that puts your infant at a relatively high risk of low birthweight. This is a cultural challenge.8 The fact that biological race categories do not exist in a consistent or logical sense means that we cannot safely rely on them to diagnose and treat people with health problems. Cultural race groups may be relevant and important to determining the best course of action to help people in some cases. But it's vital that we keep it clear in our minds that there is a difference between biological race and cultural race. The lay concept of race can easily trick us into making false a.s.sumptions about our genes, ancestry, and medical needs. For this reason, belief in biological races clearly has no place in a doctor's office, in hospitals, or in the development of drugs.