Watched The Prestige again recently. It’s the Nolan film in which his psychopathology is the least evident.

You know your conversation is getting interesting when it’s too loud even for New Yorkers.

We are catching up with some old kiwi friends at my favourite LES apero spot and the topic turns ontological.

Whilst Dawkins et al are now just a bit too 2008, a bit too outré in London circles, this is evidently not yet the case in New Zealand.

One of these kiwi friends is the lead developer for the country’s best news website. She also has a degree in mathematics and a postgrad qualification in… whatever, I don’t know. You get the picture.

So it’s easy for you to imagine her sitting front-row centre -a stack of hardcovers in her lap- whenever Dawkins or Sam Harris or whoever is on the latest of the endless round of ‘Big Idea’ science book tours deigns to visit Auckland while their plane refuels.

And like most fans of these six-figure-advance, overwritten, padded-out feature articles, my friend evidently dreams of the day she will one day get to use all this ‘knowledge’ in a debate with an ardent Deist.

This was not that day.

Each time she would spout an unsubstantiated article of Faith – for instance “memory functions like it does in a computer; held in slots in the brain”; and I responded with if it’s physical, then how does memory survive molecular replacement? – she would immediately respond with “that doesn’t mean you can leap from that to the conclusion that God exists.” Don’t actually recall making that leap.

My friend is Fiji Indian and her whole family is fairly robustly Hindu. In fact, despite them quickly defacto-ing up, all through her courtship she had to keep a separate apartment from her gasp!-white-boyfriend-now-husband. (When they covered his skin in tumeric for the wedding, he looked like something out of The Simpsons. It was cute.) Anyway, it doesn’t take a psychiatrist to suggest an earthly origin for her crusade against Spirit.

Throughout our night, her husband would laugh and say “he’s got you there!” I’m not sure if it’s because he’s more interested in science than scientism or because he’s had to sit through this particular rant more than once and nobody has yet bothered rebutting with non-spiritual responses.

The non-local effects of consciousness do not have her convinced so I point her to Pim Van Lommel and Sheldrake’s telepathy studies completely gazzumping a professor of anatomy at University College London.

However the molecular replacement thing utterly stops her in her tracks.

“I hadn’t thought of that.” Pause. “But there has to be a rational, physical explanation.”

No there doesn’t. There might be. This is science… not the last two minutes of an episode of Scooby Doo.

This is, of course, the problem with Dawkinsism/Rationalism™ -and why it has so rapidly fallen from favour with urban intelligentsia. It can only exist by ignoring vast tracts of data… an act which is the very definition of unscientific. Telepathy -which can’t exist in a materialist universe- is an actual thing. It is an Alexandrian solution to collapse Rationalism™ but in no way even chinks the gleaming edifice of genuine scientific enquiry.

And it’s not alone.

For the sake of exposition, let’s look at one of the least reputable, most maligned and self-evidently absurd corners of quackery… let’s look at homeopathy.

Snake-oil-free snake oil

HRH Prince Charles may be a fan, but here in the UK there is talk of having homeopathic remedies re-categorised as confectionary because of sustained attacks against its position within the health service.

In some ways, you can see why the product so upsets “scientific” minds.

It upset me too until I spent more than a single second looking at it.

Your typical homeopathic solution will be created with one part of an ‘active ingredient’ (which can be as ridiculous as F-Sharp or a cicada wing) and 99 parts alcohol or water… depending on what the remember calls for.

This process is then repeated up to thirty times, with some banging and shaking thrown in for good measure. As Cambridge lecturer Dr Michael Brooks says

[I]f you started by dissolving a tiny amount of your remedy in fifteen drops of water, you would end up with the original substance diluted in a volume of water fifty times bigger than the Earth. The big scientific problem with this is that when the homeopathic pharmacist sells you a few  milliliters of the remedy, the math of the chemistry tells you there is no chance that it contains a single molecule of the original substance.

The founder of homeopathy, Samuel Hahnemann, knew this and attributed the formulae’s efficacy to that ever-unhelpful catch word, “energy”.

With other forms of alternate treatment, it’s easier to grokk just how something might work within the bounds of a creaky materialist paradigm. Acupuncture, for instance, could potentially trigger nerve reactions that impact pain thresholds or some other kind of Roswell/weather balloon baloney excuse.

It doesn’t, it turns out. And indeed it performs much better if you place the needles along the relevant meridians rather than just randomly stick them in a body.

But given that the size of the clipboard carried by a doctor can affect how quickly a hospital patient recovers, it is easy in the case of homeopathy to invoke the dreaded ‘P’ word.

Placebo

We all know what a placebo effect is. It’s when somebody behaves as if they have been administered with an effective treatment when they have not. When you think about it, in and of itself it’s a kinda insulting term. This is what Saint Taleb says:

It is a very recent disease to mistake the unobserved for the nonexistent; but some are plagued with the worse disease of mistaking the unobserved for the unobservable.

Which isn’t to say modern medicine is bunk and we should all just ‘wish’ ourselves free of AIDS.

There is no doubt that modern medicine works very well. Yet it has important limitations that are becoming increasingly apparent. The great advances of medicine over the last century are running out of steam. The rate of discovery is slowing, despite ever-increasing investment in research. There is a dearth of new drugs, and medicine is becoming prohibitively expensive.

The mechanistic approach is at its best when dealing with mechanical aspects of the body, like defective joints, decayed teeth, faulty heart valves and blocked arteries, or infections curable with antibiotics. But it suffers from tunnel vision: all living organisms, including people, are physico-chemical machines, or ‘lumbering robots’.

As wizards know better than most, giving something a name in no way indicates you understand what it is. Even more significantly, naming something can sometimes give Bad Men control over a power they probably shouldn’t.

Here’s a fun little example of how the most commercially successful anti-depressant in history is no better than a placebo and what that implies for how you get a dangerous chemical into the international marketplace and make billions. Also from The Science Delusion:

For example, in several clinical trials, the antidepressant drug Prozac had slightly more effect than the placebo, and was licensed for use, resulting in annual revenues to the manufacturers of more than $2 billion. But was it really better than a placebo? Perhaps not. Although the trials were double-blind, Prozac has some well-known side effects, such as nausea and insomnia. Both patients and clinicians might have realised who had received the Prozac and who the placebo by noticing these side effects, or their absence.

This is called ‘breaking the blind’. Once some people realised they were receiving the real drug and others realised they were getting the placebo, the placebo would have become less effective, and hence Prozac would have seemed more effective by comparison.

In a study in which doctors and patients were asked to say whether they had received the real drug or the placebo, 80 per cent of the patients and 87 per cent of the doctors were right, as opposed to the 50 per cent that would be expected by random guessing.

However, in several other clinical trials, Prozac was no better than the placebo. One reason could be that in these trials the patients had less experience with antidepressants and were less able to recognise the side effects.

However, the drug company, Eli Lilly, did not publish the results of unsuccessful trials, which were revealed only because an independently minded researcher, Irving Kirsch, managed to obtain the data using the US Freedom of Information Act.

He found that when all the data were taken into account, not just the positive results published by the manufacturers, Prozac and several other antidepressants turned out to be no more effective than placebos, or than a herbal remedy, St John’s wort, which is far cheaper.

Ironically, the suppression of the data showing that Prozac was no better than a placebo probably helped to increase its effectiveness as a prescription drug, because doctors and patients had more belief in it, thus enhancing the placebo response.

Staying in the wizard’s wheelhouse, placebo effects differ along cultural lines:

[I]njecting people with saline solution often brings about cures, even though no drug is used. Placebo injections are especially effective when people have a strong belief that injections are magically powerful, as in rural Africa and Latin America. Placebo injections also give bigger placebo responses than placebo pills in the United States, but in Europe they do not.

Messing up the maps in the wheelhouse just a bit, placebo effects are actually increasing.

In 2009, placebo responses turned out to be increasing – especially in the United States. In clinical trials, fewer and fewer new drugs beat the placebos. In other words, more and more drugs failed in clinical trials, causing big problems for drug companies.

Why have placebo responses increased in the United States, but not elsewhere? The answer may be that drug companies are victims of their own success. In 1997, direct-to-consumer advertising for drugs was made legal in the United States, and as a result US citizens have been deluged with advertisements for prescription medicines.

Many of these commercials evoke uplifting associations between pills and peace of mind. The pharmaceutical industry’s advertising has been all too successful in raising expectations about new drugs, increasing the placebo response in clinical trials, and hence reducing the difference between the placebo and the drug being tested.

Which brings us back to homeopathy. Everyone assumes its efficacy lies in the power of placebo, but as Dylan Evans points out in Placebo, a 1997 meta-analysis in the Lancet that -contrary to popular opinion- has yet to be professionally refuted indicates that homeopathy does indeed outperform placebo… something Prozac doesn’t do.

He does, however, come down on the same side of Faith as my friend in the wine bar: [I]t would be foolish indeed to cast aside the whole of physics, chemistry and biology -supported as they are, by millions of experiments and observations- just because a single study yields a result that conflicts with their principles.

Three things come to mind:

1. Wizards, like fools, are oft to rush in.
2. Explain to me how following data is foolish? (See above.)
3. A single study?

The Natural History Museum

I’ve actually recommended the book that changed my mind on homeopathy and I’m pretty sure none of you took me up on the suggestion. (Or at least, none of you said that you did which is even more mean because I wanted to discuss it.)

Anyway, in it, Michael Brooks describes his visit to a homeopathic factory in Kent, where he was shepherded around by a former engineer, Lawrence, who was converted to homeopathy when it cleared up his chronic skin condition almost twenty years ago and subsequently pursued a career in it:

It’s easy, in Helios’s basement, to see what’s wrong with homeopathy. It has, largely, become the preserve of people who want to believe in the healing power of anything and everything “natural”. The range of homeopathic remedies is so vast, so all-encompassing, as to make it virtually impossible to test homeopathy’s claims…

There are remedies on the shelves at Helios that have been made from condoms, pieces of lava, the blood from an HIV-positive man, and even the whiff of anti-matter.

What’s right about homeopathy, what it has going for it, is that someone like Lawrence is genuinely frustrated by this situation. I could see the embarrassment in Lawrence’s eyes when I mention the musical remedies, and I feel a genuine empathy for his predicament. He says he doesn’t have anything to do with these remedies but he can’t stop others from “potentizing” them. He believes homeopathy works, but he knows he doesn’t have a clue why, and the extraneous stuff on his shelves isn’t helping anyone find out.

Sidebar: shades of magic, much??

Thing is… people are beginning to correlate homeopathic source ingredients with substances known to be efficacious treatments.

One of them, a botanist at the Natural History Museum called Vilma Bharatan, even did her PhD in it.

Dr Bharatan selected a source group that a botanist would know well -flowering plants- and combined them with the symptoms they are supposed to treat as well as their claimed homeopathic effects.

In the end, her matrix of data comprised more than a quarter of a billion plant remedy effects. (Her PhD dataset was apparently the largest the museum had ever analysed.) Over to Dr Brooks:

The output of a cladistics program is called a cladogram. It looks like a kind of family tree. The cladogram that shows how insects evolved into their various forms, for example, branches off first for beetles. The other branch then splits into one branch for ants, bees, wasps and another that branches into two again: one branch is the butterflies and moths, the other branch is the flies. From this picture we see how recently two species descended from a common ancestor.

In most cases, Bharatan’s homeopathic cladogram showed very few biological relationship between the homeopathic source ingredients. However, some showed very strong correlation.

Look at the raw data for a million years, and you would never see these groupings, Bharatan reckons. Because the plants are used in such a wide variety of treatments, there is no way you would normally think of grouping them according to the systems of the human body. Nor do they belong to the same biological family…

In fact, all thirteen plants in the [cardiovascular] clade contain chemicals that are used in Western medicine in the treatment of heart-related problems: angina, heart pain, and irregular heartbeat, for example…

[T]he fact that the cladistic program found a pattern associated with systems of the human body challenges the idea that homeopathy works through placebo.

The hot dog

So we have some evidence that links some base ingredients known to have allopathic efficacy continue to provide effects in substances that no longer contain a single molecule of active ingredient above and beyond the placebo effect… an effect which itself is mysterious enough on its own.

Right here, with homeopathy is another Alexandrian Solution to rigid materialism™. Because the next step in understanding these data probably requires you to say that

• Some substances have ‘energetic’ capacities we currently can’t measure (much like inedia) that can persist in the absence of physical source material.
• Some substances -especially water- have an ability to carry a ‘ghost imprint’ that is neither molecular nor energetic.

That second point brings to mind probably the only good bit of that cult-recruiting film from a few years back, detailing frozen water’s capacity to react to non-physical stimuli. We may yet be lucky enough in our lifetimes to live under regimes that explore the currently ineffable relationship of consciousness to sub-molecular and molecular worlds but the gnostic in me isn’t holding his breath.

And you know what?

Sometimes this can get you a bit down. Having just got back from the US, where we saw endless TV commercials advertising brand name pharmaceuticals -one of which was essentially just speed (adult ADHD treatment)- whose televised side effects include death ... A world in which global investment in (for example) homeopathy and the impact of intention in the health system can feel like it is a long way off. Dr Sheldrake puts it better:

If the state-sponsored monopoly of materialism is loosened, scientific and clinical research could look at the role of beliefs, faiths, hopes, fears and social influences in health and healing. Systems of therapy could be compared on the basis of their effectiveness, and people could choose those that are likely to work best for them, with the help of informed advisers.

Diet, exercise and preventive medicine programmes would also be compared on the basis of their effectiveness.

The nature of placebo responses and the power of the mind could become valid fields of research, as would the effects of prayer and meditation. An integrative medical system could empower people to lead healthier lives. Doctors and patients could become more aware of the innate capacity of the body to heal and could recognise the importance of hope and faith. More people could be asked how they would prefer to die, whether at home, in a hospice or in intensive care.

Yet here’s the thing about apocalypse pharmaka.

For you -to a large extent- that world is now. You don’t need to cite homeopathy’s ability to trounce the placebo effect in unrefuted meta-analysis. “Because fuck you” is a perfectly legitimate answer in a world that had Prozac tricked upon it.

Returning to our night on the tiles in New York, we had all had our fill of wine and yelling and decided it was time to eat. I lead us up to Crif Dogs in the East Village. My ex-Hindu friend orders the only vegetarian thing on the menu.

I turn to her, eyebrow-raised. Vegetarian? She looks at me sheepishly.

It’s amazing what will persist after you remove all source material.

[Disclaimer: This blog mentions ghosts, wizards, aliens, Atlantis, spells and fortune telling. If you consider any of that to constitute medical advice then you need to have a good, long look at how you are living your life.]