WDDTY Then And Now: 1998 interview with Lynne McTaggart

In November 1998 the Independent published an interview with Lynne McTaggart. We thought it might be interesting to see what’s changed since then.

Its hundredth issue, published in July 1998, included a letter from a doctor that condemns it as “inflammatory, scare-mongering hyperbole”.

OK, so that’s still the same…

So what are Lynne and her team doing to upset the medical establishment so much? Simply, she says, telling the truth.

That was as false then as it is now.

“It’s all about disclosure of information,” she explains. “Medicine is a sort of private conversation between doctors. We feel that we have to make this private conversation public; the public has the right to know so they can make informed choices about healthcare.”

Here’s the progress WDDTY has made towards that aim:

tumbleweed

Meanwhile we’ve seen the advent of peer-reviewed open-access publishing, initiatives to make clinical trials more transparent, books containing proper evidence-based critique of medicine and so on. The thing that all these have in common is that quacks and quackery apologists had nothing whatsoever to do with them.

WDDTY and its fellow travellers such as Natural News and Mercola.com have a problem when it comes to critique of medicine and medical science: they want to replace treatments for which the scientific evidence may be flawed, with treatments for which the scientific evidence is often entirely lacking. Antivaxers can’t improve vaccines because their criticisms are not based in reality so cannot be incorporated into the scientific discourse around vaccines. Homeopaths cannot improve medicine because they have no insight into disease or treatment. It’s like creationists trying to improve the accuracy of radiocarbon dating.

Her sources, she says, are impeccable: reputable medical journals of all kinds. “In medical literature doctors admit all the flaws; they talk about how mammography isn’t working and about how we aren’t getting anywhere with breast cancer. But that is not the face they give to the public; to the public they say it’s all getting better, we’re doing better than ever with cancer, and it’s just not true.”

Whether it was true then I can’t say but it’s certainly not true now, and again the comparison does not come out to WDDTY’s advantage. Compare WDDTY’s treatment of screening with that of Margaret McCartney. One is a simplistic anti-medicine spinning of something doctors actually do tell you (support for PSA screening is largely political not medical these days), the other is specific and contains figures that can actually be checked and verified. The result? A review of the age extension of breast screening, for one thing.

The closing statement implies that we’re not doing better than ever with cancer. That’s rubbish, of course. It’s trivially easy to compare cancer mortality over time as the ONS publishes the data. Guess what? Five year survival has doubled since the 1970s. And this is due to reality-based medicine, not quackery.

Lynne does not set herself up as any kind of medical expert: she is a journalist, pure and simple.

It’s hard to argue with the fact that McTaggart is not a medical expert, but is it true that she does not set herself up as one? She pretends to be a specialist health journalist, but her articles consistently fall short of basic journalistic standards of accuracy and fact-checking.

“I’m just presenting the information. I’m never prescriptive,” she says.

If that was ever true (debatable), it’s certainly not true now.

“We say ‘The evidence shows this; you decide’.

Really? So the publication of relentless anti-vaccine propaganda is not aimed at influencing readers’ choices? Hard sell, that.

And what about all those cases where the evidence is blatantly misrepresented?

“They (the researchers) say that chemotherapy is “completely worthless” and that cancer sufferers would do better by avoiding the drugs altogether”. – WDDTY

Our study has been misquoted and misinterpreted—I believe on purpose—by several of these groups. The researchers themselves, on hearing the bullshit above.

And what happens when a false claim is drawn to the attention of McTaggart and her editors? Why, they dig in and pretend it’s somehow not false.

” She has an editorial panel of 25 doctors she describes as “either pioneers or whistle-blowers on the system”; one, for example, was working on vaccines with the extremely powerful US Food and Drug Administration, and became so disillusioned with safety standards that he left.

“Josephine Jones” has checked the status of the editorial panel. Doesn’t look good, does it? Unless you are a paranoid conspiracist who subscribes to the delusional belief that being challenged by the medical establishment is a validation.

Lynne’s crusade began a decade ago when she was ill with symptoms that conventional medicine and several alternative therapies failed to cure. Eventually, after two years of chronic illness, she found a doctor who specialised in allergies and nutrition who was able to help.

Classic alt-med conversion narrative. The alternative – that she just got better – is not considered. It must have been the last of the numerous random alternatives she tried. Obviously.

Her experiences led her to remember how, earlier in her career, in her native America, she had worked on the Chicago Tribune with the late Dr Robert Mendelsohn, one of the first doctors who dared to criticise modern medicine.

Whoa, that’s new. Robert S. MendelsohnW was the spiritual father of Dr. OzW, freely mixing well-reasoned analysis with ideological nonsense, with no distinction made between the two.

The significance here is that Mendelsohn was educated and worked in the tradition of authority-based medicine. He was right to say that much practice in the bulk of his career was due to belief as much as evidence. That changed after the work of Archie CochraneW in particular; by the 1990s modern evidence based medicineW had taken firm hold. So the indoctrination McTaggart may have received from Mendelsohn may, ironically, have been precisely analogous to the approach he criticised, and the polar opposite of the “follow the evidence” approach he and others advocated.

Further freelance work on health and medical issues filled her with even more missionary zeal. She launched What Doctors Don’t Tell You in 1989: within a year she had 1,000 subscribers; there are now 25,000 in the UK and the US, and the newsletter led to a series of booklets and brochures, then a book.

Ah yes, the brochures.  You have to admire the chutzpah: a series of publications that mix ideological bullshit with ill-concealed advertorial, and that’s a “benefit”.

Three years ago, she launched Proof!, a newsletter which investigates alternative medicines; it too is doing well, with around 7,000 subscribers.

Edited, I think, by Pat Thomas, whose devotion to evidence can be judged from the fact that she apparently believes in astrology and works with Neals Yard.

“There’s a lot of garbage out there in alternative medicine,

Yes there is. Much of it in the pages of WDDTY!

a lot of people spending a lot of money, and natural doesn’t always mean safe. There are some problems with it,” she says. “We wanted to be a sort of consumer association of medicine, alternative and otherwise; Proof!’s the Which? of alternative medicine.” Her latest venture is a new magazine, Natural Parent.

So, where are all these stories critiquing quackery? Or does she mean things like claiming homeopathy rather than long-term antibiotics cures non-existent “chronic Lyme disease“?

her work makes sobering reading: after all, once you have debunked both conventional and alternative medicine, what’s left? “We’re not debunking either of them completely,” she insists.

Well, that’s true enough. She rebunks alternative medicine and embunkens real medicine. And before you complain, embunkens is perfectly cromulent.

“We’re just trying to separate the wheat from the chaff. Conventional medicine has its place for certain things and alternative medicine has its place. Conventional medicine is fantastic for real emergencies that require all the medicine gadgetry – if you were having an emergency caesarean or if you were dying from an infection and really need an antibiotic. If you have Addison’s disease you can get cortisone; if you have diabetes you can get insulin and you can live.”

Minchin’s Law: alternative medicine, by definition, either hasn’t been proven to work, or has been proven not to work. The name for alternative medicine that has been proven to work is: medicine.

But here’s something that puzzles me. On what objective basis would you decide that, say, emergency caesarians are valid but vaccines are not? Vaccines save literally millions of lives, far more than emergency caesarians. And what about elective caesarians, for example in breach or placenta praevia? The problem is that once you start looking at evidence instead of ideology, most of the things McTaggart promotes disappear in a puff of logic.

But, she says, for major, chronic illnesses, conventional medicine can suppress the symptoms but not cure the causes.

This deserves to be highlighted as it’s a major alt-med trope.  While it’s technically true that medicine can only manage the symptoms of chronic disease, and not cure the disease itself, this is because chronic disease is defined as disease that cannot be cured. Syphilis used to be a chronic disease, now it isn’t, it’s curable.

And even then, how much of a problem is this? Ask a type I diabetic if insulin is a good idea or not. One day it is likely that a fully curative therapy will be found, but in the mean time “suppressing” the symptoms with insulin is a hell of a lot better than the alternative. Untreated type I diabetes is fatal. Prior to the discovery of insulin, you would often find whole hospital wards of children dying from diabetic ketoacidosis.

“Your GP has been taught ‘We do this because we do this, we’ve always done it’.

That wasn’t true then and it isn’t true now. It might have been true when Mendelsohn went to medical school in the late 1940s.

But often standard treatments haven’t been put to the test to see whether there is evidence that they work and are safe.”

This was a misdirection then and is even more so now. Obviously many are not based on randomised controlled trials (how would you ethically do this for, say, surgical excision of a malignant tumour?), but newer – and, increasingly, many established – interventions are subject to test. Regardless, the fact that some treatments may be due to tradition not evidence is a reason for testing those treatments, not for abandoning the enterprise of evidence-based medicine in favour of ideology and anecdote, which is what WDDTY promote.

Like what? “To give just one big example: ultrasound screening for pregnant women is now standard practice. It was never subjected to one single study. There are now some studies looking at ultrasound that are not definitive but disturbing, but we have to stop and ask the questions before we use this technology. Medicine is not conservative; they rush out with breakthroughs; they say ‘Gee whiz, we’ve got this new technology, let’s use it!’ Everybody gets carried away.”

Read the FDA information on diagnostic ultrasound. Compare that with the headlong promotion of commercial claims for a treatment that has yet to even start Phase I clinical trials, in the pages of WDDTY.

Medicine is conservative. That’s why alternative medicine is alternative. People who want to pursue a treatment in which they believe, in the absence of robust evidence, are not being conservative. But then,. WDDTY subscribes to the classic alt-med extension of the naturalistic fallacyW: simply being alternative makes it inherently safe and effective, because no practitioner selling a lucrative treatment would ever dream of making indefensible claims.

She believes that most doctors are ill-informed about much research. “The doctors aren’t the bad guys here; it’s the system and the tools they are given. They have a ridiculous schedule – they don’t have time. This is my full-time job; they’d need to do two full-time jobs to do what we do here.”

Well, possibly, but the solution is not to send their patients in wilfully mis-informed. That only makes matters worse.

“When the newsletter launched and we did radio and TV things, they would always put me up against some doctor. The doctor would say ‘You’re destroying trust between doctor and patient!’ and this sort of stuff. When the book was launched in 1996, I would be pitted against a doctor and the doctor would be agreeing with me. We came away thinking ‘We’re not radical enough any more!’ There’s been this whole movement in these last 10 years to much more disclosure and openness, much more partnership between doctor and patient.”

And now what? They mostly ignore you, I guess. And when they do allow you airtime they very much do put you up against a doctor.

I’m astounded that Lynne thinks this is an evidence-based publication. It’s anything but […] The problem with evidence is that it can tell you things that you’d rather not know. A lot of the time medicine does do harm but that’s why doctors and scientists are duty-bound to put their research findings out there and to stop doing things that cause harm. What we shouldn’t do is abandon medicine and the scientific method and go straight for alternative medicine with no good evidence that that works either. – Dr. Margaret Mc Cartney

Dr. McCartney also criticised stories in the magazine as “absolute rubbish” and “ridiculously alarmist”.

And Dr. McCartney is a critic of the medical establishment.

Also, she points to evidence of the growing faith in alternative medicine. “Many more patients went to alternative practitioners in the past couple of years than to their own GP – the figures show it both here and in the States.

Yes, quacks specialise in treating the worried well.

The only problem is that a proportion of these people will become believers, and then when they get something like cancer they will waste precious time on quackery before seeking medical treatment. People who use alternative medicine and get cancer, believe they are healthier but actually fare worse even after controlling for the fact that they typically present later and with more advanced disease.

Guess what? Magazines like WDDTY are partly to blame. Yup, if you tell people that alternative cancer cures work, the risk is that they might believe you.

And then they die.

And people are also aware of evidence showing that drugs are the fourth greatest cause of death after heart, cancer and stroke. More and more people are taking this on board and you hear all sorts of people from all sorts of backgrounds saying ‘I don’t want to take that drug, I don’t like taking drugs, I’d like to try something else’.”

So don’t take the drug, but substituting bullshit is not a great idea – unless you’re selling the bullshit of course. And if you can get a column in WDDTY to present your bullshit, so much the better!

However, she says, a certain number of doctors still accuse WDDTY of “writing trash”, particularly when they warn of the highly controversial possible dangers of vaccinating children.

Any responsible doctor will criticise WDDTY’s advocacy of anti-vaccinationism. That’s because WDDTY, like most antivaxers, is utterly irrational on the subject.

Lynne is chairing a WDDTY debate on the pros and cons of vaccinations later this month. “We have managed to convince three leading people who are pro-vaccination to come and debate with the people who are anti. I hope that we’re getting a reputation for being fair – we’re trying to work on that. The fact that we’ve got these people to be on the same podium, which they usually won’t agree to, I think says a lot for the perception of what we are about – we try to give everybody a fair shot.”

This much has changed: these days the reality-based community is much more likely to no-platform antivaxers.

To be fair, this interview was in 1999, when the fraud in Wakefield’s papers was not yet unmasked. Now, WDDTY have no such excuse.

Five hundred tickets for the debate have already been sold and the rest are expected to go quickly. (For a former event, several hundred people were turned away.) “Our vaccine handbook sells better than everything else we’ve got,” says Lynne. “There is so little information out there, for British parents particularly. It’s a big issue, a terribly scary one: you’re going to pump antigens into your new, totally healthy baby. Usually, what parents hear on television is a big shout-fest where the two parties are given about two minutes each to try to give their side. Everybody is shouting over each other and there’s a lot of emotional stuff.

It’s only “scary” because of the hysteria whipped up by antivaxers, though. Ask the boomers’ parents about vaccines. Most people born before the 60s will have lost friends to vaccine preventable disease, seen people suffer from polio. Richard Saunders of Australian Skeptics has made a marvellous documentary, a series of personal reminiscences of the dread induced by these diseases in our parents’ and grandparents’ generations.

“We are going to make this a really formal debate, with the chance for the audience to ask a lot of questions. We need to make sure that this is kept an honest and a straightforward debate of the issues, without the emotionalism and hysteria which happen on both sides.”

Irony. It’s like coppery only harder.

Is injecting us with a regular and healthy dose of unvarnished medical information going to be her life’s work? For the foreseeable future, yes, she says. She feels a strong rapport with her readers and believes she is genuinely contributing to society. “Helping others is part of maintaining good health. It gives your life a meaning and a structure, and this is one way of helping others.”

This is undoubtedly true: McTaggart sincerely believes she is presenting the truth and helping society.

That’s what makes her such a danger.

WHAT YOUR DOCTOR WON’T TELL YOU

And why not…

About the Pill

‘Most studies have been able to justify that the Pill is safe by turning pregnancy into a dangerous disease. This risk-benefit equation only works if you believe it is better to risk breast cancer, cervical cancer, a stroke or thrombosis – all known risks associated with the Pill – than to have an unwanted baby or to use a condom instead.’

This is a wilful distortion of the facts, and is still being repeated (e.g. “Contraceptive pill increases breast cancer risk three-fold”, 7 Aug 2014.

The pill has small, well documented risks,  including a small risk of some cancers but a reduction of risk in others – some of these risks evaporate when you compare (correctly) with childless women not ont he pill, rather than all women not on the pill. However, birth control is a seriously beneficial public health intervention. Unwanted pregnancies have massive health and social costs: the pill is widely used because it is effective, the failure rate in correct use is much lower than for condoms.

About cancer

‘Then-US President Richard Nixon declared the “War on Cancer” in 1971. No cancer incurable then is curable today. Chemotherapy’s modest successes are almost identical to what they were then. Since then, all the billions of dollars of research we’ve thrown at cancer haven’t influenced survival one little bit. For most of today’s common solid cancers, the ones that cause 90 per cent of the cancer deaths every year … chemotherapy has never been proved to do any good at all.’

This is a wilful distortion of the facts, and is still being repeated today, e.g. “From the orthodox perspective, the War on Cancer is decisively being lost” in the editorial preceding November 2013’s “new light on cancer” cover story.

Aside from the rather obvious fact that Nixon was a politician not a doctor (how’s George W. Bush’s “war on terrorW” going these days?), the claim that the “war” is “definitively being lost” is, frankly, bollocks. Five year survival has doubled since 1970, it’s in excess of 90% for some cancers, and a few cancers are even preventable (so much better than cure!) e.g. by HPV vaccination (against which WDDTY, of course, fulminates with characteristic inaccuracy).

About mercury amalgam dental fillings

‘What would you say if you heard that doctors had selected one of the most toxic substances known to man, hadn’t bothered to do any safety testing before placing it permanently in your body, and continued to maintain steadfastly that there was no danger whatsoever that any of it was doing you any harm?’

This claim was “probably false” in 1999, and is definitely false now. The safety tests have been done. Mercury amalgam is safe. That doesn’t stop WDDTY advocating removal (indeed, most issues seem to include it).  Removal of amalgam, unlike amalgam in situ, does present exposure risks:

If your fillings are in good condition and there is no decay beneath the filling, FDA does not recommend that you have your amalgam fillings removed or replaced. Removing sound amalgam fillings results in unnecessary loss of healthy tooth structure, and exposes you to additional mercury vapor released during the removal process.

Aside: What’s really amusing is to watch amalgam cranks trying to justify the idea that the US Environment Protection Agency (EPA) is not a reliable source for the fact that amalgam and thiomersal are safe, but is a reliable source for the fact that elemental mercury is dangerous.

About back pain

‘Treatment for back pain aptly demonstrates how knife-happy many surgeons are without much in the way of evidence that operations will do any good.’

Possibly true in 1999 (though probably not), definitely not true now.

There is so much bollocks about back pain in WDDTY that it’s hard to work out whether or not they are still actively flogging this particular dead horse.

About cholesterol

‘We have never been able to prove a cause-and-effect relationship between cholesterol and heart disease, only that heart attack victims are assumed to have high cholesterol levels, which in turn are assumed to be the cause of hardened arteries. It’s also been assumed that a high dietary cholesterol intake causes a high blood cholesterol level and sets off a chain of events leading to a heart attack. In fact, cholesterol-lowering may be one of the biggest red herrings of the century.’

WDDTY are still flogging this one (usually in the context of their agenda against statins, or “statin drugs” as they like to call them).

WDDTY is still saying that LDL cholesterol is “good” as of December 2014. The medical profession still isn’t, despite what WDDTY want you to believe.

About doctors

‘Many of the treatments we take for granted have been adopted and widely used without one single valid study demonstrating that they are effective and safe. The so-called “gold standard” respected by medical scientists as the only scientific proof of the true worth of a drug or treatment is the randomised, double-blind, placebo-controlled trial … very few of the treatments considered to be at the very cornerstone of modern medicine have been put to this most basic of tests – or indeed, to any test at all … New Scientist recently announced on the cover of one issue that 80 per cent of medical procedures used today have never been properly tested.’

This is a well-worn myth.  The source for the low figure for treatments based on evidence is a small survey from the North of England in 1961, before evidence based practice really took hold. Bob Imrie took the time to track the source down and assess the reality.

The actual figures vary by area of practice, Imrie summarises them thus:

[P]ublished results show an average of 37.02% of interventions are supported by RCT (median = 38%). They show an average of 76% of interventions are supported by some form of compelling evidence (median = 78%).

Many of those not subject to RCT, are likely to be cases where an RCT would be difficult, dangerous or impossible. For example, antivaxers harp on endlessly about the lack of RCTs of vaccines, but these would be unethical because you’d have to expose unvaccinated people to a preventable infectious disease.

It’s also important to remember that the majority of treatment interventions are made within a small subset of these available treatments. Antibiotics for bacterial infections, for example. Most of these drugs will have compelling evidence, and RCTs here will be the norm.

Meanwhile, WDDTY continues to peddle untruths about the status of treatments November and December 2012, for example, featured coverage of the BMJ Clinical Evidence review of the treatments available to doctor, repeating claims that had been debunked years previously.

So, still alive issue, and no sign of lessons learned in the intervening period.

About medical research

‘The greatest reason that medical research is tainted is that the majority of it is funded by the very companies who stand to gain by certain results. These drug companies not only pay the salaries of researchers, but they can often decide where – indeed, whether – they get published. It’s wise to keep in mind that this industry, in a sense, has a vested interest in ill health: if drug companies found cures, rather than lifelong “maintenance” therapies, they’d soon be out of business.’

That’s chiropractors you’re thinking of, not drug companies. The problems with medical research are well documented: embarrassingly for Lynne McTaggart, the trailblazers here are people like Simon SinghW, Ben GoldacreW and the like.

The people who mount effective criticism of current practice, are very often also well-known critics of quackery, because the issue is the same in both cases: self-serving manipulation of the data by people with vested interests. WDDTY essentially pretend that this is a problem only with medicine, and that the solution is to discard medicine’s problematic claims and substitute the even more problematic claims of quacks.

Put like that it doesn’t sound like such a great idea, does it?

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