John August: Hello and welcome. My name is John August.
Craig Mazin: My name is Craig Mazin.
John: And this is Episode 281 of Scriptnotes, a podcast about screenwriting and things that are interesting to screenwriters. Except not today, because today on the podcast we’re not going to be talking about screenwriting at all. Rather, we’re going to be looking at the practice of homeopathy and what it can teach us about how narrative shapes belief.
Craig, are you ready? Are you set?
Craig: I’ve been looking forward to this. Of course. Like beyond. This is the moment I’ve been waiting for, my whole life.
John: And so much have you potentized your umbrage on this topic?
Craig: It’s weaponized. I’m bringing weaponized umbrage today. Yeah.
John: Yes. And you do that by diluting your umbrage down, so it’s just infinitesimally small.
Craig: That’s right.
John: But then that makes it much more powerful.
Craig: Yeah. By having no umbrage whatsoever, my umbrage will be that much more effective.
John: It’s going to be great. So, let’s talk about what homeopathy is, just so we’re defining our terms properly. So, homeopathy is a system of alternative medicine. It’s based around the idea of like cures like. That is that a condition can be treated by use of a substance that is similar to it, or creates similar symptoms. So, a practitioner of homeopathy is called a homeopath. And they create treatments through the process of homeopathic dilution, which is what we were referring to right there, where substances are repeatedly diluted which is believed to increase their potency.
John: So, Craig, how much did you know about the history of homeopathy before we started this episode?
Craig: I knew a bunch, because I was pre-med, so you tend to study the history of medicine. I took a great class in college called The History of Medicine, which was wonderful. And also I grew up in New York and then New Jersey and Hahnemann – there’s still a very large Hahnemann Medical Center in Philadelphia. And so I knew the name Hahnemann. And quickly came to learn how stupid everything he believed was. [laughs]
And I’ve always been this way. I’ve always felt like this strange person walking the earth who doesn’t understand why so many people believe things that are just absurd. And so I naturally gravitate towards them to learn about them.
John: Absolutely. So we originally were going to have this as part of our fact and fiction episode, where we were talking about courtroom stuff and other sort of weird, like hospital things, and like we had so much to say about homeopathy that we couldn’t fit it all into one episode. So, this is going to be the full-on – this is the tasting menu, everything you could possibly eat about homeopathy will be in this episode.
So, let’s dig in. Let’s start with the history of homeopathy, because I knew almost nothing until I started researching it this morning.
So, some of the ideas behind homeopathy go back a very long time. That sense of what can make a man ill can also make them healthier, so that goes back to sort of prehistoric times, but very early sort of philosophers talking about how the body works. Granted, they didn’t have a great sense of how the body worked overall, but there was that sense of like, oh, you have a little bit of this thing which will make you feel better because it’s like that thing.
So, that goes back a very long ways, but the guy you were referencing, Samuel Hahnemann, was the guy who sort of came up with the term of homeopathy and is really the mastermind, if you want to say mastermind, behind the whole “science” – air quotes – of homeopathy. So, talk us through sort of where he came from and sort of what is guiding principles were.
Craig: Well, Hahnemann was German and his belief was that small things that were similar to the diseases that they might treat could work. So, if you were suffering from a disease that was caused by – let’s say like for instance malaria, that was a famous one. Then, if you could find some substance that caused the same symptoms as malaria, but just give people tiny amounts of it, that should kill malaria. There’s actually no reason to believe this whatsoever. None.
Craig: It is essentially the ultimate begging of the question. They just decided that it was true. And then went from there. Now, in defense of Samuel Hahnemann, who was working in the 18th and 19th Century, no one knew a damn thing back then. No one. They were really struggling.
John: This is the era of bloodletting and leaches. Medicine, as such, was pretty barbaric. And so when you approach something with like, oh, I’m going to approach this with “scientific rigor” – air quotes again – it seems very impressive because it seems like you are trying to really suss out the origins of the problem. So, what you said about malaria, this actually fits into – he was translating a book by William Cullen, and Cullen had sort of cited that Peruvian bark, this cinchona, was useful in treating malaria. And he said it was because of its bitter and astringent properties. And so when Hahnemann was doing the translation of this book, he made a big footnote saying like, oh, it’s not just that. It’s because it caused symptoms similar to the disease it was treating. So, literally in doing the translation he sort of changed the translation to say, oh, it’s not just this bark is useful. It’s useful for exactly these reasons.
It turns out that the bark was useful because it had quinine in it. And so quinine cures malaria. But he was making a leap of logic to say like this is the reason why these things are working.
Craig: Yeah. This period of time, it’s somewhat tragic, because Hahnemann dies in the 1840s, but as you get into the second half of the 19th Century, suddenly things start to turn. And that’s when you get Louis Pasteur. And that’s when you get this enormous explosion of proper science dealing with microbes and disease. And that’s also where you start to find vaccinations come into play. And some people might think, well, this is a little bit like vaccinations. It’s not. It’s not at all like vaccinations.
Vaccinations are – the science behind vaccination is to take something that causes a disease directly and then weaken it and give the body a small amount of that weakened version so that it can create an immunity to that without suffering from the effects. Homeopathy is about finding things that cause the same symptoms and then saying, oh, that will cure it.
Or, as we’ll see as it develops, taking things that maybe cause a problem and giving you an amount that is essentially not really there.
He is a victim of the time he was in. No such excuse for the people who believe in this baloney today.
John: Yeah. So, what Hahnemann was doing, he set out to do his provings, and by provings, it’s not that he was testing the validity of his underlying premise. It was really basically just saying like, well, what are some things that cause similar symptoms? And basically he was looking for and testing on his family and everyone else around him what can I give you that’s going to cause these symptoms, because if it causes these symptoms then I can use it to treat diseases that sort of have the same symptoms. And so he was gathering up all this “research” – again, air quotes – putting together his findings, and his complete overview was called The Organon of the Healing Art, which was originally 1810.
First off, The Organon is just a great title.
Craig: Amazing, right?
John: The sixth version, which came out in 1921, is still used by homeopaths today. So, that’s where he introduced the concept of miasms, which are infectious principals underlying chronic diseases.
John: And so we can see what he’s doing here. He basically – he has a postulate. He has this idea, but rather than trying to prove this idea, he just sort of builds from hit, and builds this whole big system on top of this idea without ever trying to prove the underlying idea. And sort of when he has to come up for an explanation for things, he invents new words. And in inventing new words, he also invents new words for things that already exist. And so traditional medicine he calls allopathic medicine, which is sort of used pejoratively for all that other sort of normal stuff that isn’t the real good homeopathic stuff.
Craig: Yeah. So it’s not enough to come up with a principle and then instead of testing the principle for truth simply just start exploring things that might help you further the cause of your principle, you also had to demonize everything else because of this competitive sense that there must be an answer. And this is really the stuff of cult or religion. You begin with an article of faith. Everything that you pursue begs the question that the faith is true. And other practices that question your faith are bad. It’s just straight up religious.
John: It is. And also along those lines, you need to have an opponent. And that opponent can’t just be a passive thing that’s out there. So, it’s one thing to call everyone out there who was doing the normal medicine allopathy, but you have to have someone who is actively against you. And that became the medical establishment. The growing medical establishment that says no, no, no, this is not actually real; what you’re doing does not actually work.
And so early 20th Century popularity of homeopathy began to wane. There was this report called the Flexner Report, which is an evaluation of medical schools, and found that the schools teaching homeopathy were lacking. Medicine itself had become less barbaric. We talked about Louis Pasteur. We have the dawn of microscopes. We have the ability to look inside and see what’s actually causing disease. And what’s causing disease does not seem to be these underlying miasms. It was actually something visible now with modern technology.
So, by 1950, there’s no homeopathic colleges in the US. There were estimates of only 50 to 150 practicing homeopathic physicians in the US. And a lot of those practitioners were older because they had started at an earlier age. And so for a while it looked like it was going out. And then it came back.
Craig: Yeah. A little bit like measles.
John: [laughs] Indeed. Funny how that works. An idea that roars back into life. So, not just in the US, but Great Britain, and in France, India, you see homeopathy in lots of places worldwide. I see it when I go into the pharmacy in France. It is a thing that has come back roaring. And there’s not good science behind it then or not good science behind it now.
There’s actually a lot of good science around it now, but it’s all sort of negative. So, before we get into sort of the reasons why it doesn’t work, we should talk about – let’s talk about the storytelling that happens in this history, because I do find it just so fascinating. Because you mentioned cults, and as I was reading through this I was reminded a lot about sort of all the early churches. Look at sort of the origins of really any church that set up in opposition to the orthodoxy of the time, or even like Joseph Smith and Mormonism. You look at L. Ron Hubbard. There are charismatic people who are challenging the system. They’re saying the normal system isn’t working. I have secret knowledge to share. And don’t listen to those other people when they tell you that what we’re doing is crazy.
Craig: They’re picking at this thing that we have, or just a normal human state of mild paranoia. And the normal human state of mild paranoia stems ultimately I think from our mortality. So, on some level we’re told that we’re going to die. That is very hard to process. It just doesn’t – the brain is not particularly good at reflecting on its own lifespan and eventual demise.
So, we begin to wonder if maybe everything is not true. Perhaps this is all an illusion. Or I’m not going to really die, of course. And even if that’s subconscious, you are suddenly susceptible to people who come along and say you’ve been fed a bunch of lies, and you probably always suspected that you were fed a bunch of lies. What if I could show you the truth?
This makes for wonderful movies but terrible medicine.
John: Absolutely. So, the characters we’re describing in Hahnemann and L. Ron Hubbard, Joseph Smith, they wouldn’t be classically the hero of a story. I mean, I guess there could be some sort of call to adventure, but more likely they are the wise old man who shows up to tell the hero, “No, no, no, there’s a better way.” They are Morpheus in The Matrix. They are Obi-Wan Kenobi in Star Wars. They’re the person who says the world you see is not the world that has to be. The force permeates all things. There’s more to this world than they will let you know. That’s the function that these characters tend to play in these stories.
And you can see why they’re seductive because we don’t want the world to be the way it is. We want the world to be the way we want the world to be. And if someone offers you that solution, you’re going to say, well yes, show me how to do that.
So, in homeopathy, the key to getting the world the way you want it to be is dilution. So, we need to talk about the concept of homeopathic dilution, because that’s sort of an article of faith you kind of have to take. And say like, well, I know that doesn’t make sense, but trust me, it works. But let’s talk about sort of what’s really going on there and sort of the mathematical problem that comes with this dilution.
Craig: Well, I mean, for starters, you just have to look at the words and kind of gawk that anybody ever bought it. They’re saying if you dilute things, you make them more powerful. That is simply the opposite of true. It’s not not-true. It is the opposite of true. It’s like saying if you shine a light, something gets darker. It is just defying the meaning of the words.
John: That’s an article of faith. That is basically I know that everything you’ve ever seen works a certain way, but trust me, it doesn’t work this way in this case. You’re asking someone to make a big change in belief right there. Like that is the fundamental ask I think of homeopathy is like I know this seems crazy, but no, it really works.
Craig: And, you know, for a long time what they were talking about was essentially invisible to the eye. So, you could accept it if you chose, just like God is invisible to the eye and people choose to accept God. So, Hahnemann creates a scale, the centesimal or C scale. And this scale is a measurement of how diluted a substance is. Remember, these are substances that either mimic the symptoms of your problem or directly cause your problem. But, of course, we’re not going to just feed somebody the thing that’s causing them the problem. No, we’re going to dilute it. That will somehow make it stronger and also beneficial. So, we’re going to dilute a substance by a factor of 100 at each level of C.
John: So, a 2C dilution would take a substance that was diluted to one part in 100, and then that diluted solution is diluted again by a factor of 100. So, it’s like two 100s down.
Craig: Correct. So, essentially one/ten-thousandth, right? And so each time you do this, I guess it’s logarithmic, right? I think that’s the proper use of the mathematical term. So, by the time you get to 6C, you’ve taken a substance and you’ve diluted it to one part in 100, then you’ve taken that dilution and diluted that one part in 100. And then you’ve done it again – take that, and dilute it one part in 100. And so and so on. And Hahnemann remarkably – now, we all know, like everyone has heard, every kid has heard the story of the guy who says I bet you that a king – if you give me one penny on one square of a chessboard and then double that for the next square, I will take that as my payment if you fill up all the squares. And before long, the king is out of money because when you double things it gets bananas really quickly.
Well, Hahnemann didn’t care. He advocated 30C dilutions for most purposes. 30C, that means one in a hundred, and then take that and make that one in a hundred, and do that 30 times. So, apparently according to physicists, the greatest dilution that is reasonably likely to contain even one molecule of an original substance is 12C. And 12C, John, what is that equivalent to?
John: That is a pinch of salt in both the North and South Atlantic oceans.
Craig: I mean…
John: A pinch of salt.
Craig: One pinch. [laughs] One pinch of salt in an entire ocean. That’s 12C. Hahnemann wants 30C. So, if you want to make 30C, you need to take one molecule and put it in a container that is more than 30 billion times the size of Earth. And then he’s saying that one molecule in the container that is 30 billion times the size of Earth will cure your disease. That’s what he believed. And, in fact, that is still what these people believe.
John: Yeah. And so there’s a footnote here or like an asterisk for like people will say how is that possible. And so the sort of modern belief among homeopaths – not all homeopaths, but some homeopaths – is that there’s a sense of water memory. So, basically the process of dilution, it has changed the water to some degree. There’s a memory of what that substance was in there and it has changed the water, so it still has the effect. And that is completely inconsistent with our understanding of water. And how things work in the real world.
Craig: Or anything.
John: So, you can take a vial of water that has been treated and a vial of water that has not been treated and there’s no scientific test that can determine any difference between the two, and yet that is the belief.
So, again, that is faith. That is a belief in an invisible thing that is happening there that cannot be measured. And that’s troubling. Yet, we should say like it kind of doesn’t – maybe there is some mechanism that is actually doing it. And so I think we have to step back and say, well, even if we don’t know quite the mechanism behind it, what does it matter if it works. I mean, Craig, if it works, it works.
Craig: Oh, yeah, listen. I mean, that’s the nature of science. If we don’t understand something, but we see that it has an effect, we try and figure out why. We know things – there are things that happen now, we’re not quite sure why. We’re still trying to figure out why people sleep. But we know they sleep. We’re just not quite sure why it’s necessary. And so we’re trying to figure out the answer.
That, of course, is different than we don’t see anything happening, but maybe something is. As it turns out, if homeopathy worked we would be hard at work trying to figure out why.
Good news, everybody. Homeopathy, of course, does not work.
John: Yeah. That’s a sad thing. Because we can actually study it. And we can study to see whether it has the effects it claims to have. And it doesn’t.
Craig: No. Not even close. And I hate that we have to do these studies. It’s so absurd. So, Australia, the Australian National Health and Medical Research Council reviewed more than 1,800 studies on homeopathy. And let’s just stop right there and go, oh my god. Right?
John: That’s a lot of studies.
Craig: The waste of money and time. You might as well do 1,800 studies on whether or not somebody humming is going to cure their own cancer. It’s insane. But because some dude came up with this baloney in the 1700s, we have to have 1,800 studies. And, oh, big shock – they only found that 225 of those were even rigorous enough to analyze. And why? I suspect because 1,575 of them were sponsored by homeopathic institutes and were absolute crap.
But when they looked at the 225 rigorous studies, they found it does not work.
John: Yeah. There’s no good quality evidence to support the claim that homeopathy is effective in treating health conditions. I share this frustration with having to spend the time to research these things. I mean, it’s good that even if we do spend the time to research these things, and we spend the money, and you got to check them. And it’s important to check even things you think work to make sure that there’s not sort of research or bias in there. But, yeah, it’s maddening.
When we were preparing for the original episode, you had done specific research on one type of homeopathic medicine, which I was not even aware of, but I think it deserves sort of a special spotlight because it’s sort of extra crazy pants. So, talk us through it.
Craig: It is. It is. Well, in its own way it kind of epitomizes the crazy pants of all homeopathic “medicine.” Actually this substance – substance – it’s a sugar pill – spoiler alert – is very popular in France. It’s actually manufactured by a French company. And you will see it being used here in the United States. I think sometimes when people buy these things they just simply don’t understand what homeopathic means, so they don’t realize what they’re buying. And they’re packaged and marketed to look like medicine. So, you’ve probably seen this in stores, those of you at home. It’s called Oscillococcinum. Or Oscillo, it’s shortened to. And it’s manufactured by a French company.
And it is sold as a cure for the common cold or a fever related to a common cold. So, what is Oscillococcinum? It is a homeopathic medicine. It is based – oh, and let me just add. They sell so much of this. Millions and millions and millions and millions and millions of dollars of this. Keep that in mind.
It is based on the theory, which I will suggest is nonsense, and you decide, of a French physician who in 1919, you know, the height of medical enlightenment, thought he had discovered a shimmering microbe that he called Oscillococcinum. You get it? It’s like oscillating. So, he believed he found this little shimmering microbe and he found it not just in one of his patient’s samples under a microscope. He saw it in all of the samples that he took from his patents who all had different diseases.
Now, as it turns out, that’s probably because his microscope was faulty and he was just seeing light. And he thought things were shimmering. Microbes don’t shimmer, as it turns out. Because this isn’t fricking Star Wars.
So, he had a bad microscope, saw an artifact in every slide he had. Another spoiler alert: no one, except for this dude, has ever found this “shimmering” Oscillococcinum microbe because it doesn’t exist. But, okay, that’s quackery level number one. Let us advance, John, to quackery level number two.
Homeopaths said, oh, you know we have this wonderful theory that if you take stuff and you reduce it down to impossibly tiny amounts, it can cure the thing that that thing causes. So, if Oscillococcinum, which doesn’t exist, causes the cold, we should reduce Oscillococcinum, which doesn’t exist, down to incredibly tiny amounts. So they harvested that from – and here comes quackery level three, John, you ready?
Craig: Okay. Where else would you get Oscillococcinum from other than the liver of ducks? Why?
John: Well, that makes a lot of sense.
Craig: Yeah. [laughs] Right?
John: I mean, there’s duck liver everywhere here. I mean, it’s super common in France, so it makes sense.
Craig: It’s common. Right. So, let’s just take some duck liver, which will definitely have Oscillococcinum in it, but we’re homeopaths, so let’s reduce it down so many times in water that, quackery level four, even if they had started – and I love this statistic – and this is true of the people selling you Oscillococcinum now. If they started with a duck the size of the sun, there still would not be a single molecule of it left in an Oscillococcinum pill based on how many times they reduce it.
Let me state that again. The duck, which does not contain Oscillococcinum because it doesn’t exist, is reduced so many times down that even if they started with a duck the size of the sun, there still wouldn’t be any molecule of duck or Oscillococcinum in an Oscillococcinum pill.
John: Here’s my question. Is it vegan? Because–
Craig: [laughs] It is. It absolutely is.
John: There’s no duck in it, because even though it’s harvested from duck, at this point there is no duck in it. So, a vegan, I think, can safely take this medicine. I haven’t Googled yet.
John: I’m sure there’s debate online about, because–
Craig: They may not be able to. And here’s why. Because while there is no microbe in Oscillococcinum, nor is there a single molecule of any active ingredient in Oscillococcinum, nor could there ever be because the active ingredient is imaginary. What there is in the Oscillococcinum pill for sure are two ingredients – lactose and sucrose. Sugar and sugar.
John: Yeah. Lactose is a milk sugar. I mean, that’s not vegan, Craig. You’re spoiling it here.
John: If someone could just make this a vegan cure, why – god, I’m so frustrated.
Craig: It’s really a bummer. They were so close. They are selling you sugar pills, not the euphemistic sugar pills. They’re selling you actual sugar pills and they’re telling you that they’re selling you sugar pills. It’s on the box. Gah.
Craig: So, I mean, I assume that this is as confusing and upsetting to you as it is to me.
John: It is sort of maddening. And I think if there’s good news is that it’s maddening to lots of other people as well. So, FTC recently proposed new labeling for homeopathic medicines basically selling the box has to say this doesn’t work, which is a bold claim. I will also link to this Alan Levinovitz article for Slate arguing that the labels may actually backfire, because when you call out the scientific validity of things, in a weird way it kind of reinforces it.
So, according to 2007 government data, Americans spend about $3 billion a year on homeopathy.
John: And the market is growing. And so time and time again studies show that when you actually say like this claim has not been supported by the FDA, they don’t actually change their purchasing behaviors. So, in a weird way it makes it clear this is an alternative to a normal system. So, I’m not so optimistic that even a label on the box will stop people from using it.
Craig: Yeah. I think the problem with the FDA warning, which is very weak sauce, and I wish–
John: And I should also say, I think it’s FTC rather than FDA.
Craig: Oh. It’s FTC.
John: So, it’s the Federal, Fair Trade – what is FTC?
Craig: Fair Trade Commission? Federal Trade Commission?
John: Federal Trade Commission?
Craig: Federal Trade Commission.
John: So it’s not the Food and Drug, but it’s actually the people who are responsible for the things you buy, rather than the drugs you take.
Craig: Got it. Well, that disclaimer unfortunately just says, “We can’t say whether or not this works.” They don’t say, “This does not work.” They’ll say, “There is no scientific evidence.” And you’re right. People ignore that, because they just think, oh, because the big pharma is making money off of it.
What they need is a statement akin to the kinds of things they put on cigarette packs. These will cause cancer. Here’s the sort of opposite label for Oscillococcinum. This does nothing. It should be in huge big words in a huge box on the label.
John: We just came back from dinner here in Paris and I was looking at this woman’s cigarette box. And it says, sort of the translation is like, “This will kill you,” in big letters.
John: I like how direct it is here. So, “Tue,” the verb for in French for killing you, is nice and short and effective.
John: So, let’s talk about the efficacy of this. Because we’ve established why scientifically it doesn’t work, but why does it seem like it works? Because people who take this are taking it not just once. They’re taking it again and again. And why are they taking it again and again? And this gets into the root I think of sort of what really happens here. I think the bigger question for why this goes beyond on homeopathy. It goes to our basic psychological nature and our inability to process why something can seem like it’s working when it’s not really working.
Craig: Well, certainly we know that there’s a placebo effect. And there’s always an ethical question around placebo effect, because it’s real. So, we know that if you convince people that they’re taking potent medicine, they have a tendency to feel better. And that’s not a fake tendency. They can actually physically get better faster. So, there’s an ethical question. What if you know something is a placebo. Should you tell everybody?
There are different kinds of placebos. The placebo effect that I think is most defensible and most common is the placebo effect that comes from very low dosages of medicines that at higher doses have legitimate effect. There doesn’t seem to be a very strong placebo effect for literally sugar pills.
So, there are some other things that are going on. For instance, you’re feeling sick and you take Oscillococcinum and, you know, the next day you feel better. You might have – probably would have – felt better anyway.
John: Absolutely. So, that’s the disease running its course. So, let’s take a common cold. Let’s say you’ve got a cold that people are usually sick for like four days. So, on day one you take this homeopathic medicine for your cold. On day two and day three, you’ve still got the cold, maybe you’re feeling a little bit better. By day four, you’re good.
So, you’ve taken this homeopathic medicine and think, well, you know what, on Monday I was sick and by Thursday I was better. So, hey, I guess it worked. Because you have no counter example. You can’t know how long a cold would have lasted if you’d done nothing. And it feels like, you know what, I took some action and I’m better because of it, so I guess it must have worked, because now I’m feeling a lot better. And that repeated again and again across a whole bunch of people, that’s why it feels like it works.
It’s a form of magical thinking. Magical thinking in general is that sense of you are trying to draw a causal relationship between two events. And sometimes it’s an action and an outcome, but it seems like those two things are related, so I guess they’re related. And that’s how we get to a lot of our beliefs about how the world works is by drawing these inferences whether they’re valid or not.
Craig: And unfortunately there’s a tremendous overlap between people who have a tendency for magical thinking and people who have no respect for the scientific method whatsoever. So, a lot of times people get a cold and they go to CVS and they pick up NyQuil and some Advil and some Oscillococcinum. And they take all of it. Well, you know, I got better. Obviously it was that magical combination of two things that are medicine and one thing that’s a sugar pill. You know? They just don’t weed out these factors whatsoever. I think that there is another subset of people who are more distressing to me than I would say just the people who are making the casual error of purchasing this nonsense.
There are people who view as medicine and their own self-care as an act of protest. And that goes back to that paranoia, you know. So-called smart people are lying to you in order to take your money. They want you to be sick, so you have to buy more of their junk. And, in fact, these are the secrets that they’re keeping from you. And not only will you get better if you take this, but you are a more virtuous person who is striking a blow for freedom and truth.
John: Yeah. That’s the more radical version of I would say like a consumerist approach to healthcare, which is basically like I’m going to keep shopping for an answer until I get the answer I want. And I’m going to pick that answer and that answer is going to be the one that has the most benefits for me and the least drawbacks for me. Factually-based is not a high priority.
So, you know, the same way we sort of shop for clothes, we want to shop for a medicine. Like, I want the one that does exactly these things, but doesn’t have any of these bad side effects. And they’re not recognized in the realities of the situation. Like, things are real.
So, I want to circle back to placebo effect because it’s such an important aspect of what’s happening here. So, most of the people who are feeling better, it probably is a placebo effect to some degree. Sugar pills are classically placebo effect. And there’s nothing wrong with placebo effect. And we should note that when drugs have to go through real FDA trials, they’re tested against a placebo.
John: And in order to be approved, they’re supposed to show that they are much more effective than, or at least noticeably or measurably more effective than an equivalent placebo. And that’s because the placebo effect is so strong, they want to measure them against–
Craig: But like think about – here’s the crazy part. If you really think about what you just said, which is absolutely accurate, what regular medicine manufacturers are doing is they’re saying we have a medicine, we think it works. Let’s compare it to Oscillococcinum. [laughs] Because if it doesn’t work better than that, it’s not real medicine. That’s literally what they’re saying. They’re saying Oscillococcinum is our gold standard for doing nothing. So let’s compare it to that.
John: Yeah. In the show notes I’ll put a link to a great episode of Science Vs. where they looked at antidepressants and whether antidepressants work, because there’s a lot of science out there that’s suggesting that in many cases they’re not noticeably better than a placebo. And so, well, what do you do? Because they seem effective in a lot of people, but it could be a placebo effect that’s doing a lot of that work there. And so that’s an ongoing scientific controversy.
I’m delighted to have that kind of controversy about a real thing rather than imaginary things.
Craig: For sure.
John: And I’d also say, we were talking about the common cold, and so some of the things we offer as solutions to the common cold really are placebos and we should acknowledge that they are placebos. It doesn’t mean that they’re not useful or palliative because if it feels good that’s sort of part of the job. Like comfort should be part of it.
So, when I start feeling a cold, my go-to is Makers Mark. Makers Mark bourbon for whatever reason, it makes me feel better. It’s probably just because I’m taking some action. It’s probably because it’s alcohol.
Craig: Ah, there you go. [laughs]
John: But it makes me feel better. In the same way my daughter starts to feel a little pukey, I’m like–
John: You give her like the one children’s Motrin. And it’s not going to do anything, but it makes her feel like something has been done. And that’s reasonable. And that’s the kind of thing I wish people would embrace rather than–
Craig: Sure. I mean, we all are – this is particularly effective for children. Because children, their brains are still forming. They’re supposed to be completely ignorant and foolable. Every parent knows that, you know, when their three-year-old falls and bumps their knee that they want a Band-Aid. They’re not cut. The Band-Aid is doing nothing. But they want it. And it will make them feel better. And that’s fine for children.
Obviously, yes, only you would wonder what magical ingredient in bourbon could possibly be making you feel better. [laughs] But there’s nothing wrong with that, of course. But there are costs to the wholesale acceptance of thorough complete nonsense. If you give your daughter three Motrin when she has a fever, it will impact the fever. No question.
Craig: It’s medicine. But there’s a cost to believing in this junk.
John: Yes. Let’s talk about it. So, I think the underlying pervasive problem for me is that when we choose to be irrational about some things, like our own healthcare, we open ourselves to be irrational about lots of things. And so there are many things out there in the world which a lot of people are kind of irrational about. Climate change. Vaccination. Conspiracies about everything, including 9/11. Psychics. Birtherism. And all sorts of other kind of non-medicines that are thrown out there as being alternatives to western medicine, many of which are actually dangerous.
Craig: Yeah, dangerous by addition because they themselves make you worse, or dangerous by subtraction because you’re using them instead of things that work. And there are some very, very sad clear examples of let’s call it homeopathic style magical thinking that has led to harm. Latril, I don’t know if you’re familiar with that word.
John: I don’t know what Latril is.
Craig: So, in the ‘70s, some ding-a-ling decided that there was this substance in peach pits that could cure cancer. And there is a substance in peach pits. It’s cyanide. It does not cure cancer, at all. And people were spending money on it and dying, not surprisingly, either because they were ingesting too much cyanide, or because they were not following a prescribed course of medicine by actual physicians, or because they were going to die. So, Latril was a huge problem.
And then you had this crazy thing that I think it’s finally going away. This crazy thing that happened where people who were HIV-positive were suddenly denying that HIV was the real cause of AIDS. They believed that, I don’t know, toxins in the atmosphere, or the – or even worse, the drugs used to treat HIV were the real cause of AIDS. And there’s a woman named Christine Maggiore who was HIV-positive and she wrote a book about this. She was kind of the champion of this movement. It gained traction. A one point the Foo Fighters were on board with this ding-a-ling.
And here’s what happened. What happened was that her daughter, named Eliza Jane, contracted HIV from Christine, who refused to take antivirals. And Eliza Jane died of AIDS at the age of three. And then Christine Maggiore died shortly thereafter from AIDS. What a shock. And, you know, if you want to die as a result of your own ignorance, I understand. But she willfully infected her own child and killed her own child. That’s just terrifying to me. Terrifying.
John: There’s also a lot of examples of situations where people, especially parents, take something that is actually a real thing and try to apply it to stuff that’s not the actual situation. So, there’s a thing called chelation which is when you have heavy metal poisoning, like seriously heavy metal poisoning that could kill a person. Arsenic, lead, mercury. And there’s a medical practice for how you do it, but parents will try to do it themselves for things that aren’t metal poisoning because they think, oh well, I’m making my kid cleaner on the inside. You can kill your kid that way.
John: And my worry is that the same type of belief system that can make homeopathy seem like great, it’s nice, it’s safe, can get a parent to chelation very, very easily.
Craig: Absolutely. Think of homeopathy as gateway stupidity. What we’re saying is homeopathic medicine can’t do anything to you. It can’t harm you. The Amazing Randi, James Randi, who is a wonderful skeptic and magician, there’s a terrific video of him swallowing an entire bottle of homeopathic sleeping pills at once. [laughs] Because there’s nothing in them, right? But that is your first step down the road of I don’t believe in truth. I believe instead of this modern phenomenon called My Truth. I hear people say this. “Well, my truth, or your truth.” No, there is no my truth. And there is no your truth. There’s just truth. Either something is true, or it’s not. And if you start wandering down the path where you decide that universal truth is less important than what you choose to be true, well, the foundations of everything real beneath your feet begin to crumble. And you will end up in trouble, inevitably.
John: Yup. So, the most recent horrible example of this was Pizza-gate. And so for listeners outside the US, or any listeners inside the US who have blissfully been able to not be aware of what Pizza-gate was, it was just this crazy scandal that sort of burst out of Reddit. It’s so hard to believe that it existed, but it did exist. But essentially these people believed that there was a child sex trafficking ring happening at a pizza place in Brooklyn that major Democratic officials were involved. Hillary Clinton was involved. There were secret code words. That it was all this big thing.
And it seemed like one of those crazy Internet things until somebody like shows up there and starts shooting. And that’s what happened. And so Pizza-gate is not the same as homeopathy, but I think it’s that same sense of like I’m going to choose to believe what facts I choose to believe, and if anyone confronts me about these imaginary facts I believe, I’m going to say that you are just trying to suppress my truth. You’re trying to conceal what’s really happening behind.
Craig: Right. Because it feels true. And if it feels true, it is true. Except that’s not how truth works. And as we proceed in this incredible age of enlightenment and technological advancement, when I look all around me I see this ever widening gap between rationalists and irrationalists. And there are so many more irrationalists than rationalists. And what’s so crazy is the rationalists are giving us everything. Our iPhones and our computers and the Internet and the microphones we’re using and the medicines that have extended our lives. And the vaccines that give us the luxury to walk around in a crowded building and not worry about getting the plague. These people are thriving and giving us everything. The irrationalists take these things and use them to spread irrationality.
So, they use the Internet, a rational thing, and they use medicine, a rational thing, and their extended life spans, and all of it to spread things that run counter to what the rationalists say and do. And I worry that we are going to end up in this crazy bifurcated world between people who are recessing backwards towards caveman-like magical thinking. And then these other people that are moving forward towards some sort of star child status. I don’t know how we lost our love of rationality. But, homeopathy is such a canary in the coal mine for me. It really is. I hate that more people are using it. It makes me angry.
John: Yup. So, let’s talk about the real problems of using it in a medical situation. So, one of the problems is just finite resources. There’s only so much money to spend on medicine and on drugs and on healthcare. And if you’re spending $3 billion a year on stuff that absolutely cannot work, that’s $3 billion that you’re not spending on research, on actual medicines that could work.
I don’t want to pretend that our modern healthcare system, specifically our modern drug system, is wonderful or ideal. It’s not. It’s messed up. It’s deeply messed up and needs to be changed. But the solution is not an invented system that has no basis in science whatsoever.
Craig: That’s right. We know for sure that heart disease kills most people that are dying of medical causes in the United States. Heart disease, number one. What if we just took that $3 billion and just donated it to heart disease research? That would be better.
John: It would be better. I mean, in some ways I think taking that $3 billion and putting it in a hole would be kind of better also, because that’s what you’re essentially doing and you’re encouraging this false set of beliefs by spending that $3 billion on these sugar pills.
Craig: It’s true. Yeah.
John: Yeah. Sort of to get around to sort of like how homeopathy represents these bigger issues, let’s look at how homeopathy started and how it all began. So, Hahnemann took a very simple idea, a simple and sort of compelling idea. It was easy to summarize that idea. He spread it by denouncing the experts. He created alternative vocabularies for everything. He renamed his opponents, so he called them allopaths, basically don’t even refer to them by their normal name.
And when he was confronted by facts, he just kept spinning. He just kept inventing new things until he died. And this is essentially, you know, we urged you before to use the term begs the question properly. This is begging the question. This is circular reasoning that’s not ever proving its underlying premise.
Craig: Yeah. It’s a bit like you know how we’re going to make America great again? We’re going to make America great again.
John: Sign me up.
Craig: Yeah. And let me just come up with a bunch of funny names for the people running against me and lies schmies. Yeah.
John: Good stuff. So, what can you do as a person, as a citizen, to look at homeopathy in a better way and sort of like help us move past our current situation with homeopathy?
Craig: Well, my advice is not to – it’s not wishy washy in any way. It’s more of an imperative. None of you should pay a single penny for any product described as homeopathic. If it says homeopathic on the box, it does not work. By definition. It cannot work. It is not even meant to work. That product exists to enrich liars. That’s it.
How often do we come across things where we can say happily, “This isn’t a fuzzy issue. There’s no middle ground. There’s no good homeopaths who are getting a bad rep from the bad ones.” The story has one side. Homeopathy is stupid and wrong. And if you believe in it, you are doing something that is stupid and wrong. And if you take it, you’re doing something that is stupid and wrong. And the only worse than doing something stupid and wrong by mistake, which we all do, which is part of the human condition, is doing something stupid and wrong on purpose, knowing it’s stupid and wrong. That’s a moral crime.
So, you want to help? Stop doing it.
John: I agree. I’d also say along with don’t equivocate, like don’t draw false comparisons. So, there are things where you sort of squint and look like, oh, that kind of looks like homeopathy. But actually investigate it and see whether it is homeopathy or not homeopathy. So, we talked about vaccinations. Yes, vaccinations, you’re taking something in to prevent a disease, but that’s not homeopathy. That’s actually a real thing. So, don’t throw out vaccination because homeopathy doesn’t work.
Same thing with like there’s allergy treatments where you’re actually building up your body’s immune system so it doesn’t react to certain things. Like they just announced a way to do that for peanuts, which is great, because that was actually killing real kids. So, there’s things that sort of look like homeopathy but are not homeopathy, so don’t confuse those things, too. Don’t throw out everything. Just look at sort of what homeopathy is doing and say like, “That’s not it.”
I like Craig’s suggestion for if you see the homeopathy, then you know it’s not real. Just replace that mentally in your head with like ineffective. Ineffective cold medicine.
John: You wouldn’t buy anything that was called ineffective cold medicine. Don’t buy something called homeopathic cold medicine.
Craig: Yeah. Or replace it with the word scam. So, scam cold medicine. Okay, yeah, I get it.
John: Although Zicam was very effective, and Zicam is a lot like scam.
Craig: Zicam is not that effective.
John: It was effective in terms of its marketing.
Craig: Yes. In terms of its marketing, you’re right. Yes, they were dancing very close to… – Hey, listen, we’re in a freaking post-Trump world now where he went to this rally and people were like Lock Her Up, and he’s like, “Oh, yeah, I remember Lock Her Up. That was funny. That played well before the election. We don’t need that anymore.”
Craig: It was like, he’s just telling them now. And they’re like, “Yeah.” [laughs]
John: He’s doing his own commentary track. That’s the crazy thing.
Craig: He is. And he’s doing what homeopathic medicine does, which is to say you should take this. It’s a sugar pill. It doesn’t work. Take it. It works. Wait, what? So, part of what people struggle with, I think, is if you take this away, what is left? And unfortunately – and this is where if you are somebody who wanted to believe in this, but maybe we’ve gotten through to you and you’re thinking, okay, okay, I submit. But the alternatives aren’t great. Well, no one promised you a rose garden. Here’s the deal with science. You can’t blame science for correcting itself. I think people do this all the time. They’re like, well, what do the doctors know? They used to say that you should do this. And then they said you should do this.
Correct. That’s what science does. Science does its best and is constantly examining itself and then changing to reflect new information. That is exactly why science is valuable. You can’t reward fake science for being consistent. That’s the hallmark of fake science. There’s no prize for being consistently wrong the way that homeopathic medicine has been consistently wrong.
So, similarly you can’t really punish science for being inconsistent. That’s part of why science works. And we know that while science may stumble and move forward and backwards, you know, two steps forward, one step back, when they do arrive at things that work, they’re life-changing.
Lipitor has saved so many lives. And it works. And it’s good. Science is ultimately a matter of statistics and best guesses and margins of error. And that is messy, I think, conceptually for people. But it turns out messy is far more effective than fake meat.
John: I agree. And let’s talk about what you can do as a writer. So, if this has inspired you to think about these topics, what can you do as a screenwriter? I would argue that you need to be careful with your narratives, because we brought up The Matrix, we brought up Star Wars. It’s very easy to play into the narrative where your hero is told that the world is not as it seems. They are standing up against a system. These are all common tropes for our movies and they’re there for a reason, but maybe think about not making the villain of your story medicine, or a system which is actually sort of there for the good.
Stand up for facts and truth in your stories. Have your heroes stand up for facts and for truth. And up against lies. That’s always a great thing. And don’t make your heroes sort of like gleefully, blissfully ignorant. Don’t reward them for their faith in an invisible thing beyond all reason. That’s my concern is that so many of our compelling stories are about that sort of belief in the invisible magical force that surrounds us in the universe. And so we see these stories and we’re just like, oh yeah, that’s right. I’m like Luke Skywalker. I believe in the Force.
And it’s like, no, no, you believe in an imaginary speck of duck liver that’s not actually there in the thing you’re drinking. That’s my concern. So, I would just argue for look for ways to tell stories where the heroes are not those guys who are believing in the impossible thing just because.
Craig: Yeah. The heroes of rationality. I agree.
There are times when the nature of drama requires you to tell an outlier story. And there are stories where people fought against the medical establishment for something and prevailed. And that’s fine, too. But when you’re telling that story, at least acknowledge that while there may be a bad guy, that science itself is not the bad guy. That, in fact, whoever is fighting this fight to advance their belief, which turns out to be true, is a scientist. They got there rationally.
So, the worst thing is when they paint… – Look, movies want to paint the world in the most simple, gleeful way. You know, folks, if you just walk outside and chew a simple leaf, like these noble savages, you will held. No. No. Those people aren’t noble or savage. That leaf doesn’t work.
The ones that do work get turned into medicine, like aspirin, which comes from the bark of the willow tree, I believe. Or, I mean, there’s a whole bunch of drugs that come from plants. And we use them. We don’t use the ones that don’t work.
Craig: You know, these people don’t know anything. I mean, really, do you think that the Oscillococcinum people are like, wow, we figured it out and then Bayer wasn’t like, “Ooh, we’d like to get in on that.” Doesn’t work that way.
John: A good friend of mine back in Los Angeles, who I deeply love, but he will consistently believe impossible things. And so about once a week I have to sit him down and really talk him through this thing that he’s thinking and really explain why it can’t possibly work. And by the end of a session I can sort of get him thinking like, oh yeah, okay, I get that. But he’s not able to sort of generalize that through to the next situation that is nearly identical to that. And I think in all of our lives there are going to be some people who are like that. And you got to pick sort of who are those people who you’re going to help walk through those roads.
So, if you’re a person who is post-homeopathy and that this has at all been inspiring you to get past your belief in some of these systems, it’s great that you’re there. Just pick up the torch and like carry it on. And get some other people in your life to be thinking rationally about some of these situations.
John: Great. It is time for out One Cool Things. So, keeping with our medicinal topic here, I’m going to say my One Cool Thing is French Pharmacists. So, yes, French pharmacists will have homeopathic medicines on the counter. They’re not pushing them, but I do see them there. But, I’ve had three exposures with French pharmacists and they’ve been remarkably helpful in ways that American pharmacists never will.
So, they will actually, like there was a problem with one of my prescriptions. They’re like, “Okay, I’ll call your doctor.” Like, they’re never going to call the doctor. But, no, they called the doctor, then they called and they said like, “I couldn’t get through to the doctor, but I’m still working on it.” Twice they did that. And then they found like cheaper ways to get things to happen. They’ve been so remarkably helpful and useful.
Another fun fact about French pharmacists. If you are gathering mushrooms out in the woods, you can take them to a pharmacist and the pharmacist will identify which ones are the poisonous mushrooms.
John: They’re trained in identifying poisonous mushrooms.
Craig: It’s so French. So French. I love it.
John: It’s amazing.
Craig: A-mazing. Well, I’ll keep in line as well with our topic here. If you are interested in being like me and John and being skeptical of bad medicine and bad science, I urge you to check out a website called Quackwatch. Quackwatch.org. it is not a pretty website. They have invested no time or energy in good web design.
However, they are a great clearinghouse for information on all of the terrible, bad medicine and medical ideas and health scams that are floating around out there. Think of it like your medical Snopes. And when someone tells you, “I’ve that blah, blah, blah,” go check it out on Quackwatch.
Sometimes things are new and sometimes things are effective. A lot of times what you’re hearing is pre-packaged or repackaged/reheated crap. And Quackwatch will help guide you through that miasma, as Hahnemann would say.
John: Fantastic. That is our show for this week. So, as always, our show is produced by Godwin Jabangwe. It is edited by Matthew Chilelli. Our outro this week comes from Tim Minchin. He’s the composer and lyricist of Matilda.
Craig: Wait, what? [laughs]
John: And the upcoming Groundhog Day.
Craig: Wait, wait, wait, what?
John: He did not compose this specifically for us. This is something I found online where he talks about homeopathy and I felt it was so appropriate that even if it does not have a [hums], it should be our outro for this week’s episode.
Craig: My heart stopped there when I thought it was, like, oh my god, Tim Minchin listens to our show.
John: Yeah. I know.
Craig: He’s like my hero.
John: That Broadway and medical outrage combination. Like it’s Craig’s day.
John: Tim Minchin lives in Los Angeles apparently. Did you know that?
Craig: You’re kidding. I want to hang out with him so bad. So, I don’t know if this clip is from Storm, his incredible poem.
John: It’s related to Storm, but it’s not from Storm.
Craig: I think Storm was one of my prior One Cool Things. God, I would do anything just to hang out with that guy for an evening. Anything.
John: So, our sense of like we would do anything to meet has worked once before where we met the wonderful Kates from Australia.
Craig: That’s right.
John: This guy is also Australian. He’s in Los Angeles. Somebody who listens to the show knows him. So, maybe we’ll make this happen.
Craig: Make it happen.
John: All right. If you have an outro, or you’re Tim Minchin and wanting to write into us, you can write to email@example.com. That’s also the place where you can send longer questions.
On Twitter, I’m @johnaugust. Craig is @clmazin. We’re on Facebook. So, if you have not already left a comment about our last topic, where we talked about transgender issues, you can let us know what you thought about our homeopathy episode.
Craig: Heavy fire.
John: Heavy fire. You can find us on iTunes. Just search for Scriptnotes. That’s also where you’ll find the app to download. Some people were having problem with the app. It’s great that you wrote in to me, but it’s also great if you write into the folks who actually make the app, which his Libsyn. So, even though it’s underneath my umbrella of a company, it’s actually the folks at Libsyn make the app. So, if you find a technical issue with it, talk to them because they are the ones who interface between the library and everything else. They can help you more than I can help you on the app.
At johnaugust.com you’ll find transcripts for this and all of our episodes. Between Godwin and John who does the transcripts, they are up about four days after the episodes. That’s also where you can find transcripts for all the back episodes and the show notes for today’s episode. We’ll try to have a lot of links in there for the things we talked about.
And, Craig, thank you so much.
Craig: Thank you, John.
John: All right. Have a good week. Bye.
- What is Homeopathy?
- The History of Homeopathy
- Oscillococcinum – “Oscillo”
- FTC Labeling
- Science Vs #11 Antidepressants
- French Pharmacists
- John August on Twitter
- Craig Mazin on Twitter
- John on Instagram
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- Outro by Tim Minchin (send us yours!)
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