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CAM on campus: Black History Month

I emerge from the haze of board exams and residency interviews to blog about a recent development on campus that disappointed me, involving a university celebration of Black History Month.

To provide context, I must tell you that my medical school campus has the university hospital for a poor city full of immigrants and racial minorities. White citizens make up about a quarter of the city population. I am extremely proud of our faculty and students who strive to serve our surrounding community. Some of these efforts are based, predictably, in medical care. This care is provided not just by working in the hospital and clinic, but also by promoting health and prevention through community health fairs and mobile outreach programs. Other efforts are aimed at helping local kids get to college and into health-related careers. Establishing a physician workforce that represents a diversity of racial, ethnic, and cultural backgrounds is considered an important step in reducing racial disparities in health care access and outcomes (e.g., 1, 2), and that mission is embraced wholeheartedly at my institution. (An anecdotal example of the diversity in our school and hospital: it is neither rare nor surprising for me to look around a random gathering and realize that I am the only pale, American-born man in attendance.) Therefore, one might expect my university’s celebration of Black History Month to be kind of a big deal.

Here is the announcement for our university-sponsored celebration of Black History Month. The title of the speech that kicks off the celebration is “Holistic Medicine – Ancient Africans to African-Americans.” The next event is a screening of a video called “Hidden Dangers in Kids’ Meals: Genetically Engineered Foods.” Clearly the celebration is being used to address health concerns in the black community, which seems entirely appropriate for a medical university. However, as regular blog readers have already predicted, I found myself getting increasingly upset about the particular topics chosen to meet this worthy goal.

I am upset not simply because my skeptical hackles raise at the term “holistic medicine,” but because I feel that here is an example of CAM ideology marring an opportunity for meaningful service. The most charitable word I can use for the topics listed is “controversial.” Airing of controversial views can certainly be appropriate in a university setting, but not if and when the goal is supporting the health of a historically disenfranchised part of our community.

Guest speaker on “holistic medicine”

Local physician Kevin Holder, MD gave a talk titled, “Holistic Medicine – Ancient Africans to African-Americans.” I am sad that my clinical duties prevented me from attending the talk. I will refrain from speculating on its content, but one might infer what Dr. Holder means by “holistic medicine” from the website of his Center for Preventive Medicine, particularly the “Our Philosophy” and “Our Team” pages.

From the standpoint of understanding the history and current prevalence of unconventional health beliefs in African and African-American communities, I can appreciate this topic as germaine to Black History Month even if I would disagree with Dr. Holder as to the medical value of those beliefs. It is a shame I missed the event, because it might have been a great opportunity to have a discussion about the appropriateness of incorporating pre-(non-)scientific philosophies into a modern medical practice. It is a fascinating question: where should we draw the line between hard-nosed adherence to science-based medicine and pragmatic appeals to a community with strongly held traditions? Perhaps the celebration organizers had in mind to foster such a debate.

The cranky skeptic in me cannot help speculating, however, that it was explicit sympathy for CAM-like philosophies in the planning committee that resulted in the scheduling of both Dr. Holder and the subsequent, much less defensible event.

Screening of an anti-GM food movie

The next event is a screening of “Hidden Dangers in Kids’ Meals: Genetically Engineered Foods” by anti-GM (genetically modified) food activist Jeffrey Smith. Here can be found the 24-minute video for the brave, and below is an outline for everyone else:

  • Ominous music opens the video, and scattered throughout are gripping quotes like “I don’t want to sell my children’s future for a handful of magic beans.”
  • Descriptions of how the industry controls research programs and regulatory bodies (I do not know to what extent this is true) are plentiful, along with stories of individuals being pressured or even expelled if they ask the wrong questions or voice the wrong opinions. An analogy is made to tobacco companies spinning science about cigarettes.
  • Frequently cited experiments document the horrible effects of a particular GM food on a group of laboratory animals. Interestingly, there seems to be no consistent pattern in the particular adverse effects cited; it sounds like GM foods can cause just about any pathology.
  • Anecdotes are also offered about adverse effects in farm animals, ranging from the mysterious death of twelve cows in Germany to “The cows didn’t care for it” in Iowa.
  • Broad claims are made for the effect of food on behavior. An unidentified study apparently showed that “25% of tantrums in 3-year-olds [were] due to additives or colorings in their food.” A Wisconsin school that instituted sweeping changes in its lunch offerings and cafeteria environment reported a resulting improvement in student behavior and attention. Neither of these dramatic examples, of course, specifically involved GM foods. But the audience gets the message that healthy food is better than processed junk, and presumably they can make the connection from there.
  • Another example of this implicit yet bold assumption—that GM food is associated with all manner of ills—is the closing statement that begins, “With the rise in obesity and diabetes…” and ends with concerns about GM food.
  • At one point the video creator Jeffrey Smith, to his credit, speaks carefully about not being over-confident about conclusions based on a single, small experiment in animals. He says it “would be irresponsible,” however, not to proceed cautiously until better studies are done. The audience is left to take his word that better studies than these have indeed not been done.

The most detailed, science-y part of the video involves the implications of an article published in Nature Biotechnology titled “Assessing the survival of transgenic plant DNA in the human gastrointestinal tract.” Jeffrey Smith describes how transgenes were shown to jump from GM soy to bacterial flora in the human gut. He expresses concerns about transfer of antibiotic resistance genes, pesticide production genes, promoters that might insert themselves anywhere in the new genome… It all sounds pretty scary until you read the abstract of the Nature paper, which ends with “we conclude that gene transfer did not occur during the feeding experiment.” Reading the full article in order to judge the researchers’ conclusion versus Jeffrey’s opposite interpretation is left as an exercise for the blog reader.

Finally, for those who like a good “Quack Miranda Warning,” the one at the end of the video (at 8:40 here) is amusing.

A scathing critique of Jeffrey Smith’s claims and use of evidence can be found here, at a site that appears to have been founded by a couple of food science professors fed up by this guy. I do not have the time and patience to wade through it, but suffice to say that the creator of the video “Hidden Dangers in Kids’ Meals” looks an awful lot like a crank to me. The link to Dr. Gorski’s favorite Health Ranger, Mike Adams, on Jeffrey Smith’s home page increases my suspicion. I welcome any comments by blog readers better versed in this field or with this individual.

The purpose of screening the Jeffrey Smith video for Black History Month eludes me. Only a handful of the activists, experts, parents, and innocent children depicted had much melanin in their skin. But more importantly, I do not think we support a marginalized community by promoting fear of greedy corporations and complicit government. Raise your hand if you think a conspiracy theory about food is what black Americans really need right now.

Honoring Black History Month by serving black Americans

For my university, a public celebration of Black History Month is not simply an exercise in honoring diversity. Our school and hospital are prominent institutions in a city of many black children who could benefit greatly from inspiration and guidance. I applaud the goal of using the celebration to spotlight the health of Black Americans, which by many metrics lags deplorably behind the health of other racial groups in this country. A particularly salient problem is the high rate of obesity in this population, making all the more potentially valuable a program to promote healthy lifestyle and diet.

I wish, however, that this intention had found a different execution than holistic medicine and anti-GM hysteria. Here is an alternative: how about featuring First Lady Michelle Obama’s “Let’s Move!” initiative? She is focused on urban children’s health, though her concerns are more about access to fresh produce and safe playgrounds rather than exposure to GM foods. Our mayor Cory Booker recently kicked off the Let’s Move! campaign in this city and is using Facebook to lose weight himself. The messages from this campaign could have been tailored to black youth (include yoga for exercise if you want some CAM) and used as part of the Black History Month celebration instead of the dubious health messages we are sending now. Even better than the non-magical, non-paranoid character of the Let’s Move! campaign: its national and local leaders are terrific black American role models. (Of course, I appreciate that it would be very difficult to secure either of these high-profile individuals for a guest appearance. But I bet there are other folks in our city working on this problem…)

Americans, whether African- or any other kind, deserve from their medical universities the truth as best as we know it. We can do better than this misguided, misleading, fear-mongering video.

Posted in: Medical Academia

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24 thoughts on “CAM on campus: Black History Month

  1. LovleAnjel says:

    Ugh, that’s deplorable. It sounds like since underserved minorities have limited access to quality healthcare, someone is trying to convince them that it’s in their best interests no to get it anyway, so don’t worry about it.

    That’s like the argument “some people don’t have health insurance so they have to do CAM instead.” It’s disgusting. Society should not be ratifying second-class citizenship like this.

  2. S.C. former shruggie says:

    From the South Orange Center for Preventative Medicine:

    Traditional (allopathic) medicines do not address the root issue of disease.

    Of the famous Three Kinds of Lie, that would be a damned lie.

    However, that is not a cause to abandon pharmaceuticals.

    Because the pharmaceuticals do “address the root issue of disease,” and the CAM doesn’t, but they’d like you to use the real treatment and then give their magic fairy dust the credit.

    And what’s the deal with food activists? I can’t off hand think of a kind of literature surer of being dishonest and full of imaginary horror stories than that promoting dietary changes.

    Wow. This is a real shame.

  3. Draal says:

    “A scathing critique of Jeffrey Smith’s claims and use of evidence can be found here, at a site that appears to have been founded by a couple of food science professors fed up by this guy. … I welcome any comments by blog readers better versed in this field or with this individual.”

    I perused the scathing critique briefly. Overall, Smith makes one Slippery Slope logical fallacy after another. Smith rails against genetic manipulation b/c it can potentially create unwanted phenotypes. What Smith fails to point out is genetic manipulation occurs all the time in Nature (aka evolution), especially using traditional cross-breeding techniques. GM organisms, on the other hand, can be characterized extensively in the lab to select for genetically-altered organisms that meet very strict guidelines for both genotype and phenotype characteristics. Smith described other known genetic mutation mechanisms like horizontal gene transfer and extrapolates out to the very worst possible scenarios. For example, we ingest GM food carrying it’s altered DNA. Smith proposes that our gut microflora could then pick up the plant derived genes like an engineered anti-microbial gene and make a resistant bacteria. This scenario has already been studied with no evidence of horizontal gene transfer detected. It’s not to say it can’t happen but its a very unlikely. I guess it could be summed up as a scare tactic.

  4. windriven says:

    Life expectancy at birth in, to choose an African country, Nigeria is 47.24 years (CIA factbook).

    Life expectancy of an African American is (roughly as there is a considerable difference between males and females) 68 years.

    So much for “Holistic Medicine – Ancient Africans to African-Americans.” Where in the Ancient African Holistic Pharmacopoeia are statins, for instance? Let’s compare African American lives prolonged by statins versus those prolonged by jojoba.

  5. JMB says:

    GM foods have been a source of debate in Africa. The debate is the risk of famine versus the risk of GM food. Different countries in Africa have different policies towards GM food. By presenting just one side of the story during Black History month, they are being biased. If it is history, then they should discuss the different responses to GM food by the different governments in Africa in the last decade, and the results of those different policies. If it is a medical school, they should discuss the public health issues of such history.

    In my medical school, the history of medicine lectures were some of the most enjoyable lectures, including during Black history month. We were never given a documentary film to watch in history of medicine. In fact, the only two documentary films I remember in medical school were one on diseases we were unlikely to encounter in this country (such as marasmus, dracunculiasis, Chagas disease, etc), and one on human sexual function.

  6. windriven,
    Sadly, you have asked about something that actually exists.

    T. Johns, R. L. A. Mahunnah, P. Sanaya, L. Chapman, T. Ticktin, Saponins and phenolic content in plant dietary additives of a traditional subsistence community, the Batemi of Ngorongoro District, Tanzania, Journal of Ethnopharmacology, Volume 66, Issue 1, July 1999, Pages 1-10, ISSN 0378-8741, DOI: 10.1016/S0378-8741(98)00179-2.
    (http://www.sciencedirect.com/science/article/B6T8D-3WJ6X40-1/2/2feeebd57fba06bd3ab1c3e0afa63c89)
    Abstract:
    Reports of plants added to milk and meat-based soups by the Maasai and Batemi in East Africa support a role for phenolic antioxidants and hypocholesterolemic agents in the diet, and provide explanation of the low incidence of cardiovascular disease of populations that traditionally consume high levels of dietary fat and cholesterol. Plant food additives used by the Batemi of Ngorongoro District, Tanzania, were tabulated, based on interviews with 22 informants, while 17 specimens were collected in the field and analyzed for saponin and phenolic content. A total of 81% of the Batemi additives and 82% of those known to be used by the Maasai contain potentially hypocholesterolemic saponins and/or phenolics.
    Keywords: Antioxidants; Saponins; Phenolics; Maasai

  7. (Or rather, everything we know is consistent with statins being an important element of a traditional African pharmacopoeia. Which is not the same as knowing it for sure.)

  8. I don’t really have time, but it seems I can’t resist commenting.

    For Black History History Month, I can see how a lecture on medicine today, even, cringe, holistic medicine :) and it’s relationship to ancient African medicine may be relevant, so the primary concern would be how factual the material is.

    BUT: “Hidden Dangers in Kids’ Meals: Genetically Engineered Foods” ?!?

    That is neither Black or History. There actually was a reason for using months to celebrate certain cultures. It’s to highlight the value of that culture and it’s history within the context of the current society. Something that can be overlooked in euro-centric American textbooks and schools.

    I can’t say that I participate in BHM every year, but I have had the opportunity to see a couple of excellent speakers (A local professor/poet and a army general) and I found the stories of their lives, their work and their experiences as Black American interesting and informative. That seems to me to be the spirit of BHM… not the evils of GMF.

    To use the time and budget to allow someone to peddle their book/film on a non-relevant topic seems very disrespectful to me.

  9. daedalus2u says:

    It is my understanding that vaccination for smallpox originated in Africa.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200696/

  10. Chris says:

    Yesterday while I was gardening, I listened to a fascinating podcast on hookworm:
    http://www.virology.ws/2011/02/09/twip-22-hookworm/

    Dr. Despommier went into the history of the slave trade, the Civil War and the economic depression after the Civil War. Hookworm causes iron deficiency. The white folk were eating the turnips and getting anemic, while the African Americans ate the greens and were less likely to be anemic. The greens have the nutrients.

    Also, earlier in the week the SETI “Are We Alone?” had an interview with Lonnie Johnson, a former engineer. There was discussion on inventions not being credited to African Americans:
    http://radio.seti.org/episodes/Better_Mousetrap

  11. weing says:

    “It is my understanding that vaccination for smallpox originated in Africa.”

    I’ve always been under the delusion that it originated in China.

  12. “It is my understanding that vaccination for smallpox originated in Africa.”

    Variolation is not vaccination. It’s explained in the article:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200696/

  13. # Chris “Yesterday while I was gardening, I listened to a fascinating podcast on hookworm:”

    wait, gardening? You’re killing me.

  14. Chris says:

    Sorry about that, Michele. I hope you all thaw out soon.

  15. windriven says:

    @Alison Cummins-

    The point remains – perhaps even more emphatically: the notion that folk remedies somehow trump scientific medicine is bogus. Folk medicine is still fairly common in much of Africa and, for that matter, any number of other areas. The fact that some of these folk remedies contain compounds with useful pharmacological properties is beside the point. It is science that isolates the active ingredient, purifies it, often synthesizes it, standardizes the dosage, and tracks adverse reactions to its use.

    Your link mentioned saponins and trumpeted their apparent effectiveness in preventing cardiovascular disease. But saponins can also be toxic. A recent issue of Toxicology looked at nephrotoxicity of plant-derived saponins (Toxicity testing of saponin-containing Yucca schidigera Roetzl. juice in relation to hepato- and nephrotoxicity of Narthecium ossifragum (L.) Huds.).

  16. windriven says:

    @Alison

    “(Or rather, everything we know is consistent with statins being an important element of a traditional African pharmacopoeia. Which is not the same as knowing it for sure.)”

    I’m not precisely sure what you mean here. Saponins aren’t statins, but that might not be your point. Lovastatin was isolated from a fungus but I don’t know if that fungus was found in Africa.

  17. Jan Willem Nienhuys says:

    @daedalus2u and weing

    The quoted paper states:

    Inoculation, hereafter referred to as variolation, was likely practiced in Africa, India, and China long before the 18th century, when it was introduced to Europe (9). In 1670, Circassian traders introduced variolation to the Turkish “Ottoman” Empire.

    There is a story about variolation having been invented in China in the early Song Dynasty and you can read about this story here

    http://www.gilbertling.org/lp5.htm
    and in the Wikipedia article http://en.wikipedia.org/wiki/Inoculation
    http://www.ncbi.nlm.nih.gov/pubmed/11624682

    A few years ago a ran across a paper arguing that the story that it was invented in the Song Dynasty is apocryphal. The origin of that story probably was propaganda for vaccination in China. ‘It was invented here’ supposedly came from invented stories. Also in China telling that some cure is very old is felt as a recommendation, apparently.

    Anyway, the Wang Tan (or Wang Dan) story first surfaces in 1808, at a time that vaccination was being introduced in many places.

    I can’t find my source of a few years ago, but you may consult what Madalibi wrote on August 19, 2008 on
    http://www.chinahistoryforum.com/index.php?/topic/26871-chinese-medical-advances/page__st__15

  18. Toiletman says:

    The idea of a black HISTORY month seems to be very strange outside of social sciences and especially medicine. Where is there any value in that for medical teaching? If there have been post-stone age societies in Africa (I only know of the Nok) that were not in contact with the semitic peoples and developed own medicine, we still don’t know them because they have not left any traces in this field.

  19. Toiletman – I don’t know why it would seem strange in medicine. Unless medicine is not interested in it’s history. Shouldn’t people be aware of the achievements of Black Doctors or others working in medicine? Couldn’t that be inspiring to a smart young black person?

    Dr. Daniel Hale Williams
    (1856-1931) Williams was born in Pennsylvania and attended medical school in Chicago, where he received his M.D. in 1883. He founded the Provident Hospital in Chicago in 1891, and he performed the first successful open heart surgery in 1893.

    Percy L. Julian
    (1899-1975) Alabama-born Julian held a bachelor’s degree from DePauw University, a master’s degree from Harvard University, and a Ph.D. from the University of Vienna. His most famous achievement is his synthesis of cortisone, which is used to treat arthritis and other inflammatory diseases.

    Dr. Charles Richard Drew
    (1904-1950) Born in Washington, D.C., Drew earned advanced degrees in medicine and surgery from McGill University in Montreal, Quebec, in 1933 and from Columbia University in 1940. He is particularly noted for his research in blood plasma and for setting up the first blood bank.

    Emmett Chappelle
    (1925-) Born in Phoenix, Arizona, Chappelle earned a B.S. from the University of California and an M.S. from the University of Washington. He joined NASA in 1977 as a remote sensing scientist. Among Chappelle’s discoveries is a method (developed with Grace Picciolo) of instantly detecting bacteria in water, which led to the improved diagnoses of urinary tract infections.

  20. sorry didn’t mean to plagiarize. The accomplishments section of my comment is clipped from http://www.infoplease.com/spot/bhmscientists1.html

  21. Also @ toiletman – Oh and I think the Tuskegee experiments are an important part of the Black and Medical History.

  22. daedalus2u says:

    I think it is an important part of medical education because of the pernicious effects of discrimination on both the perpetrator and the victim.

    When people are dehumanized, their possible contribution is dismissed and they are not even allowed the opportunity to be heard. I suspect that there was a great deal more traditional African medicine than there is traditional Chinese medicine because humans have lived in Africa a lot longer than they have lived in China.

    I suspect it was Colonialism that so denigrated traditional African medicine simply because it was African such that much of it has been lost. That is unfortunate. Not because I think any type of traditional medicine is better, but it can be a good starting point for hypothesis generation.

  23. Chris says:

    Michele, thanks for that website. I just visited my daughter’s high school today to see what the students had done for their lunch time diversity week displays and food offerings. I got there early and tried to read in the cafeteria, but it was much too interesting watching the students set up. I am thinking up a blog post, and I would like to highlight minority scientists, engineers and doctors.

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