In his new book Breakthrough! How the 10 Greatest Discoveries in Medicine Saved Millions and Changed Our View of the World, Jon Queijo describes what he believes are the 10 greatest discoveries. Nine of them are uncontroversial discoveries that have been on other top-10 lists, but his 10th choice is one that no other list of top discoveries has ever included.
Queijo realizes this, and even admits in his introduction that a former editor of the New England Journal of Medicine refused to review his book because there is no such thing as alternative medicine, only treatments that work and treatments that don’t. But he “respectfully disagrees.”
Hippocrates’ discovery that disease had natural causes, sanitation, germ theory, anesthesia, X-rays, vaccines, antibiotics, genetics, and treatments for mental disorders are all worthy candidates for the list. But Queijo ludicrously lists the “rediscovery of alternative medicine” as the tenth “great discovery.” He presents no evidence (because there is no evidence) that alternative medicine has “saved millions” or that it has saved anyone.
He doesn’t realize that alternative medicine represents a betrayal of exactly the kind of rigorous scientific thinking and testing that led to all the other discoveries. His list of 10 breakthroughs is actually a list of 9 breakthroughs and one breakdown.
He tells compelling human-interest stories about the discoveries. The complexities, the mis-steps, the near-misses, and the ups and downs make fascinating reading. He describes farmer Benjamin Jesty leading his wife and children on a two mile trek through the fields in 1774 to steal cowpox pus from a neighbor’s cow and inoculate his family with a sewing needle to protect them (successfully!) from smallpox. He describes the many chance events that had to conspire for Fleming to see the effects of mold on his culture plate and the long, tortuous course between his observation and the therapeutic use of penicillin. He tells how the pea-gardening monk Gregor Mendel’s discovery of genetic principles went unrecognized until decades later after 3 other researchers had unknowingly replicated some of his experiments.
He offers fascinating tidbits of historical information. Anti-vaccine activists are nothing new: he tells how they sabotaged the use of an early typhoid vaccine in the Boer War by such tactics as dumping vaccine shipments overboard from ships. As a result, the British Army suffered more than 58,000 cases of typhoid and 9000 deaths.
He recounts Roentgen’s early comments about his discovery of x-rays:
I still believed I was the victim of deception.
I have discovered something interesting, but I do not know whether or not my observations are correct.
Before he announced his discovery, he studied the characteristics of the rays, investigating whether they could penetrate various materials or be deflected by a prism or a magnetic field. One can only wish that today’s students of “energy medicine” would employ his cautious, self-questioning, and scientifically rigorous approach!
My favorite was a delightful anecdote about Thomas Edison: in the early days after the discovery of x-rays, Edison received two requests in the mail, one from an apparent voyeur asking him to fit a set of opera glasses with x-rays and the other asking him to
Please send me one pound of X-rays and bill as soon as possible.
There are hints of trouble before we get to the chapter on alternative medicine. Queijo claims that one of Hippocrates’ accomplishments was to believe that respect for a higher power was a necessary precondition for good health. What does that even mean? Why would it be important? He offers no evidence that such respect has ever saved lives or had any positive effect on medical practice.
In the chapter on genetics, he starts by describing the ancient superstition that “maternal impressions” could affect the development of the fetus: for instance, after watching a fire, a woman delivered a baby with a flame-shaped birthmark. He demolishes that possibility with a reasoned discussion of genetic principles and DNA. But then he inexplicably cites a modern study by Ian Stevenson, who holds a number of strange beliefs, is convinced he has solid evidence proving reincarnation, and could be classified as a maverick if you wanted to be polite. Stevenson collected a number of case reports and opined that
In rare instances maternal impressions may indeed affect gestating babies and cause birth defects.
Queijo agrees with him, saying
In the brave new world of genes, nucleotides, and SNP’s it’s easy to dismiss such mysteries as playing no role in the inheritance of physical traits — no more than, say, DNA was thought to have for 75 years after its discovery.
He’s wrong: Stevenson did not find any “mysteries” but merely the kind of coincidences that will be inevitably found if you look hard enough for them.
In the chapter on alternative medicine, Queijo loses it entirely. He seems to think that modern medicine has become so fixated on diseases and technology that alternative medicine had to rediscover that diseases occur in people. He criticizes the reductionism of the scientific approach, but offers no evidence that a non-reductionist approach has ever resulted in discoveries or provided better patient outcomes. He sees the struggles between scientific medicine and alternative medicine as politically motivated turf wars rather than as efforts to establish the truth. He claims that by 1998, Americans were seeking alternative care practitioners more often than their own primary care physicians. If this is true, offering that statement without qualification would be misleading to say the least. Anyway, popularity is no guide as to what treatments work.
He accepts homeopathy uncritically and even suggests that it is now supported by science. He likes the idea of homeopathy because it “shares some underlying values seen in ancient traditional medicines” such as vitalistic energy concepts, detailed interviews to inquire into every detail of the patient’s life, stressing the healer-patient relationship, and deriving many of its remedies from natural products.
Alternative medicine offered something Western medicine had too often abandoned: the view that every patient was an individual, that natural treatments were sometimes better than dramatic surgery and dangerous drugs; and that the essence of medicine begins with a caring relationship between healer and patient.
This is a straw man argument that badly mischaracterizes mainstream medicine, and it fails to show that alternative medicine has any advantage over scientific medicine practiced with judgment and empathy. If every patient is an individual and the whole person should be treated, why do chiropractors fixate on adjusting spines and acupuncturists fixate on improving the flow of qi through meridians?
He even goes as far as to accuse the stethoscope of being a nefarious device that distances practitioners from patients! He calls its invention “a dark omen for the terrible turn Western medicine was about to take.” Now, really!
Much of this book is an eloquent paean to the value of science. Unfortunately, it abandons science in its discussion of alternative medicine. It deteriorates into apologetics for belief-based medicine based on misunderstandings and opinions rather than on any evidence. Alternative medicine represents a breakdown of the process that led to the real breakthroughs.
If you read this book, I recommend skipping chapter 10.
*This blog post was originally published at Science-Based Medicine*