What's Eating Stephen Barrett?
by Burton GoldbergLet's look at this set-up carefully. Barrett and his "quackbusting" colleagues say they are working to protect the public against health frauds. They don't want the public to waste its money on "sham" treatments that don't work. In the paradox of "quackbusting," the quackbusters say they're protecting public health, but in fact, they're abandoning the public to their own suffering to protect the financial interests of conventional medicine, which has no interest in or ability to produce benefits for these conditions.
He says he's using science to protect the public from expensive fad diagnoses, but if this "quackbuster" has his way, the public will have no recourse but conventional medicine for their health problems.Recently, I set myself the exercise of trying to understand what motivates a self-proclaimed "quackbuster" to write a book debunking an entire field of medicine. A "quackbuster," as we've come to know over the years, is someone who is dedicated to casting aspersions on alternative medicine, regardless of whether there is any factual basis.
As alternative medicine continues to grow more popular-an estimated 42% of Americans now use it-the "quackbusters" are growing more clamorous in their denunciations of our field. They have to be-they're almost a minority view.Multiple chemical sensitivity, sick building syndrome, food-related hyperactivity, mercury amalgam toxicity, candidiasis hyperactivity, Gulf War syndrome-these are all costly misbeliefs and fad diagnoses, says Barrett. "Many Americans believe that exposure to common foods and chemicals makes them ill," he says. "This book is about people who hold such beliefs but are wrong."
Not only are patients wrong, Barrett says, they are "financially exploited as well as mistreated." They are duped by "far-fetched" notions and "dubious claims," by headline-crazed media and "toxic television," and by "physicians who use questionable diagnostic and treatment methods."Patients presume they are being made allergic or toxic or even being poisoned by the mass of modern chemicals, cosmetics, cleaning agents, drugs, and other human-made substances. They are mistaken, says Barrett. Their misbeliefs are especially hard to understand, Barrett says, "at a time when our food supply is the world's safest and our antipollution program is the best we've ever had."
Patients' symptoms are mental (psychosomatic) in origin-"they react to stress by developing multiple symptoms." Their symptoms are not caused by chemicals or dietary factors, he says. In fact, Barrett suggests that some patients are "hysterical," others are "paranoid," and the rest have "certain psychological factors" that "predispose" them to "develop symptoms" and to seek out "questionable" doctors (meaning alternative medicine practitioners) who will attach a ("not scientifically recognized") disease label to them.Regarding Gulf War syndrome, for example, Barrett declares: "It provides a feeding trough for serious scientists, since funding is abundant, and for every charlatan with a newsworthy theory." On the matter of the dangers of mercury fillings, he states: "The false diagnosis of mercury-amalgam toxicity is potentially very harmful and reflects extremely poor judgment."
For the most part, of the illnesses listed above, nearly all are mere "labels" rather than legitimate illness conditions, asserts Barrett; they're not caused by foods or chemicals; there are no "scientific" studies conclusively proving the association of diet, chemicals, and illness; and we are best advised to dismiss them out of hand, he says.In most cases and for most of the illnesses commonly associated with chemical sensitivity, Barrett says the mass of mistaken patients would be better off seeking "mental help" from a psychiatrist or other "mental health practitioner." Alternative medicine physicians and especially "clinical ecologists" (the old name for practitioners of environmental medicine, which links exposures to toxic substances with health conditions) should be chastised, investigated, put on notice, and if possible, put out of business, says Barrett.
Most of what Barrett claims can be refuted, easily and decisively. That's not my intention here. I'm more interested in looking at the bigger picture-what is Barrett really saying amidst his quackbusting bluster, and why?Barrett appears to be saying that the typical American patient is stupid, hysterical or paranoid, easily duped, and generally incapable of making a rational, correct medical decision on their own. The patient is mistaken and wrong in thinking their multiple symptoms have any connection to the foods they eat or the environmental chemicals to which they are exposed. The media is irresponsible and not to be trusted as an information source about medicine, especially about alternatives. Doctors who practice alternative medicine are unscientific, opportunistic frauds or quacks, peddling flawed or junk science.
I next pondered what could be the purpose of this book. What could be the result of debunking the connection between foods, chemicals, cosmetics, and drugs with the varieties of environmental illness (mentioned above) now afflicting millions of patients. Why does Barrett (and his colleagues) so dislike alternative medicine? What's eating him that he must disparage the field at every opportunity?The purpose has to be this: to corral this mass of suffering "confused" patients into the treatment pen of conventional medicine. But here Barrett's rationale collapses. The patients end up with nothing.
Surely no person suffering unexplained allergies or general toxicity wants to be told they're stupid, mistaken, and ought to have their head examined. And surely no patient who has abandoned conventional medicine (because the one or two dozen doctors they consulted hadn't a clue as to how to help them) would be interested in Barrett's thesis. It is genuinely hard to imagine how a suffering patient could actually be persuaded by Barrett to dismiss alternative approaches when the conventional ones were not useful, or even worse, were harmful.But let's say, despite these reservations, patients allowed themselves to be herded into Barrett's allopathic corral. There would be nothing there for them. Conventional medicine has no cure or treatment for these illnesses. In fact, as Barrett repeatedly points out, for the most part, conventional medicine does not even validate the existence of these illness categories and regards a diagnosis of such illnesses as bogus medicine. Of course, Barrett does offer patients "mental help."
Let's look at this set-up carefully. Barrett and his "quackbusting" colleagues say they are working to protect the public against health frauds. They don't want the public to waste its money on "sham" treatments that don't work. The false labels of multiple chemical sensitivity, environmental illness, and the rest, do the public a "disservice," Barrett says, and seeking treatment for these wastes the financial resources of insurance companies, employers, and other third party reimbursers.But since conventional medicine has nothing to offer patients who "believe" they are suffering physical distress from these conditions, the patients, in effect, are left on their own to suffer some more. Barrett's plan seems to be to corral these misguided patients into the conventional medicine pen so he can dissuade them of their mistaken notions regarding their illness and make them "see" that it's all psychosomatic.
Clearly the patients do not benefit at all from this scenario, so who does? The makers of drugs, petrochemicals, cosmetics, synthetic food additives, pesticides, prepared foods-in short, the massive food and chemical industry of North America benefits. They are no longer held accountable as causal factors in multiple symptom illnesses. They are let off the hook. They can proceed with business as usual. There are no poisons in their products. (See the cartoon about "quackbusters" by Harley Schwadron in "The Politics of Medicine" section, this issue, p. 106.)In the paradox of "quackbusting," the quackbusters say they're protecting public health, but in fact, they're abandoning the public to their own suffering to protect the financial interests of conventional medicine, which has no interest in or ability to produce benefits for these conditions. The "quackbusters" say they're serving the public, but the truth is they're grossly disserving patients. Thanks to Barrett's remarkable chemical insensitivity, a great many patients will be left to suffer on their own without any diagnosis or treatment, except perhaps another round of Prozac on the house.