Conversation with Natalie Robins
Q: What led you to write about the history of alternative medicine and its relationship with conventional medicine?
This is the first of my eight books that was someone else’s idea! Over six years ago, a family friend, knowing of my interest in medical matters, suggested to me that I look into the American Medical Association’s attitude toward alternative medicine. My obsession as a writer is to tell both sides of complicated, controversial issues, and as I began researching, I saw that this subject might just be the greatest challenge ever to this passion of mine. The AMA was adamantly opposed to alternative medicine from the outset (the organization was formed in 1847) and the alternative practitioners were on the defensive, hollering and screaming for their very right to exist from that time on. I also saw from my research that most writers did not explain the conflict in ways that seemed to me to illuminate the source of the problems between conventional and alternative medicine, but, rather, joined in the fray, writing in a hollering and screaming way themselves. So I thought that I would give it a try and see if I could take a fair-minded approach.
Q: Who is Royal Copeland? Why did you choose to use him as our guide through the book?
Royal Samuel Copeland was an eye surgeon who was also a medical school dean, health commissioner of New York during the horrific flu pandemic of 1918, and a United States Senator from New York. As Senator he shepherded through Congress the Federal Food, Drug and Cosmetic Act of 1938. Copeland was more than an ordinary doctor and Senator. He was a bit of a showman, he advertised products, he owned businesses (among them, restaurants that served healthy, fresh foods, and a laboratory that tested various products.) He wrote a famous newspaper column about health-related subjects, and he also wrote books about health and exercise — even using himself to model the various exercise positions he was promoting. Copeland was a homeopathic physician, which meant that he dispensed homeopathic remedies to his patients before, after, and even instead of, surgery. These were dilute substances made from minerals, herbs, plants, barks, mushrooms, insects, shellfish, or animal products. Trained in the late 1800s in a course no different from that of a conventional doctor, he believed that homeopathy was a “disease-shortening, pain-alleviating method” of medicine; indeed he said it was a “life-saving system.” But he also believed in conventional medicine. Still, his crowning achievement as a US Senator was to sneak the homeopathic pharmacopeia into the 1938 act, thus giving homeopathic remedies permanent legal status.
Copeland’s name came up once or twice in my early research, and when I looked for detailed information I discovered that there were no books about him, only a reprint of an unpublished PhD thesis. But I soon found out that the Bentley Historical Library of the University of Michigan had the complete collection of his papers.
Copeland, a savvy politician, believed that homeopathy and conventional medicine could – and should – live happily side by side, and he always kept up a good relationship with the AMA (despite that fact that it kept a secret file on his activities.) His often maverick, colorful life seemed to me just the one to dramatize the conflicts between conventional and alternative medicine I was learning about. I was not planning to write a full biography of Copeland but rather to use only the parts of his life that illuminated the scientific, educational, and political issues as I saw them. I worried at first that the plethora of medical facts I would need to mount my “case” might overwhelm the storytelling aspect, but I decided to take the risk, because getting it “right” (meaning, to me, even-handed) was more important than getting it “cinematic”(meaning, to me, heavy-handed.) Copeland would probably agree I made the right choice, although he might have enjoyed being on stage more often. The man loved being the center of attention.
Q: What would Copeland think about the state of alternative medicine today?
He would be gratified, I think, that so many medical schools are now offering courses in alternative medicine. (But I also think he would be concerned that not enough alternative practitioners have full-fledged medical degrees from reputable medical schools.) He would be gratified also that so many Americans are using homeopathic remedies, although at the same time he would worry about self-administration. He believed that doctors with medical degrees should be at the helm of a person’s medical care, whether it be alternative or standard.
Q: Homeopathy was fairly widely used in the United States up through the 1930s. What caused this change? Has alternative medicine become as popular once again? Is it more popular now?
Homeopathic milk sugar pellets (dilute substances made from minerals, herbs, plants, barks, mushrooms, insects, shellfish, or animal products) were gentle options to many of the harsh medical treatments of the 1800s like bloodletting, blistering, purging, or the use of opiates. Unlike the conventional doctors, homeopaths treated the patient’s symptoms with remedies similar to the symptoms (“Like Cures Like”) — for instance, using ragweed to alleviate hay fever, or bees to heal insect stings. (In healthy people, these substances caused the very disease they were meant to treat.) As I write in my book, “Because of its painlessness, lack of side effects, and relative simplicity, homeopathy caught on like wildfire across America.”
Then came certain milestone medical developments — vaccines for smallpox, rabies, typhoid, tetanus, diphtheria, cholera. Aspirin came into use, as did vitamins, Sulfa, Penicillin, and Streptomycin. By the mid 1940s, patients clamored for antibiotics they way they had once demanded homeopathic remedies.
Once the psychedelic, frenetic, frantic era of 1960s arrived and medical boundaries were once again challenged (just as they had been in the mid 1800s), it became increasingly faddish to seek unconventional medical treatments of all kinds. Homeopathy was reborn. This rebirth continues to this day, even though standard medicine has made extraordinary advances. But homeopathy has now entered the twenty-first century, and many homeopaths are doing scientific research — controlled clinical studies of remedies. Homeopathy is used by an estimated fifteen million Americans today.
Q: Is there a difference between holistic, homeopathic, and alternative medicines?
Good, but slightly complicated question! Webster’s dictionary defines holistic as “pertaining to or using therapies outside the mainstream of orthodox medicine, as chiropractic, homeopathy, or naturopathy.” (It defines holism as “the theory that whole entities have an existence other than as the mere sum of their parts.”) The dictionary defines homeopathy as “a method of treating disease by minute doses of drugs that in a healthy person would produce symptoms similar to those of the disease (opposed to allopathy.)” It defines alternative medicine as “health care and treatment practices, including traditional Chinese medicine, chiropractic, folk medicine, and naturopathy, that minimize or eschew the use of surgery and drugs.” While homeopathy is generally considered a systemic, whole-body (“holistic”) treatment, it does not “minimize or eschew the use of surgery and drugs,” at least homeopathic drugs. Royal Copeland believed in surgery and homeopathic remedies, as well as the usage of standard medications when required. Indeed he wrote in the early 1900s that “homeopathy is not a system of medicine. It does not replace surgery, hygiene, biological medicine, chemical antidote, physical therapeutics, or even the physiological dosage of the modern physician. It is but one of many methods of treatment.”
Q: The title of the book describes the “war” between conventional and alternative medicines. Is that war still being fought today?
Yes, although it is now more of a cold war. Jennifer Jacobs, MD, a homeopathic physician and pioneer researcher, argues that “nothing in homeopathy is inconsistent with contemporary physics, even though there is not a universally accepted scientific explanation for the mechanism of action.” Wallace Sampson, MD, a leading critic of homeopathy, argues that it “has cured no disease, has not extended life, and has not deepened our understanding of biology, health, or illness. The concept conflicts with the entire body of knowledge of pharmacology, chemistry, physics, and every other field of science.” Fairly insoluble (I fear) arguments.
I’m going to add a cold war note. Perhaps I shouldn’t put too much stock in what follows but somehow it serves as a reminder that winning is always on the mind of the doctors. Before I was allowed to view the Health Fraud and Alternative Medicine archives at the AMA, I was asked if I was for or against alternative medicine. I could tell that the answer was supposed to be “con,” or better yet, “con, of course.” But I answered that I had no idea how I felt – that I was writing a history – and pro or con didn’t seem to be in my equation. The questioner looked somewhat relieved, but I felt as if I had just been asked to sign a loyalty pledge. I might add that I had a similar exchange with an official at a homeopathic organization. What about a truce I wanted to say to both groups!
Q: What do you consider to be the biggest obstacle facing alternative medicine here today?
We live in an age of scientific medicine and science rules the day. Alternative medicine needs to accept this fact. The controlled clinical study must become its gold standard, just as it is for conventional medicine. In addition, educational and licensing requirements for alternative medicine must become consistent throughout the country.
Q: Why are alternative remedies and treatments considered by many to be “quack” therapies? Is part of it cultural, as many other Western, developed countries (the French, in particular) rely upon such treatments as readily as they rely upon conventional medicine?
The answer is because many alternatives are misleading in their claims, and thus harmful in both psychological and often physical ways. (Certain minerals claim to cure cancer; electrical treatments claim to cure allergies, asthma, depression; certain algae — pond scum! — for weight loss.) But the most important consideration to remember is a phrase I recently came across by Stephen Barrett, MD in an article he co-wrote with William T. Jarvis entitled “How Quackery Sells,” that “Quackery lies in the promise, not in the product.”
As I report in my book, in 1998, for the first time, one consumer group ( The National Council Against Health Fraud) suggested to the AMA’s Council on Scientific Affairs that homeopathy be taken out of the “Quackery” category and put in the “Untested” category. As “Untested” it was no longer considered “harmful.”
Q: What will it take for the public and the medical community to take alternative medicine seriously?
They already do take it seriously! Just consider how many major hospitals have alternative medicine departments! Nonetheless, many alternatives still need better universal educational requirements, regulations, and licensing procedures. Consumer groups like Quackwatch, and alternative practitioners have to stop seeing one another as “the enemy” and start talking, especially about alternative medicine’s need (probably “willingness” would be a more useful word here) to become more scientific.
Q: What was your most surprising discovery as you wrote this book?
There were three surprises for me. The first was when I learned that homeopathy is a wholly Western invention. I had always thought it was Eastern. But it was founded in 1796 in Germany by a medical doctor named Christian Friedrich Samuel Hahnemann, and arrived in America in 1827. The second was when I read Royal Copeland’s definition of homeopathy in a turn of the century medical dictionary that called it “a method of therapeutic application” that was “but one of many methods of treating sickness.” He said it was “not a system of medicine.” Many homeopaths have forgotten this, I discovered, especially those who mock most standard medical treatments. For the most part, these homeopaths hold that their way is the one and only way. Nothing else matters very much. The third surprise was that some of these same homeopaths – the ones who are not great fans of standard medicine — completely misunderstand Copeland’s motives. They think of him as a turncoat, someone who left homeopathy behind, and not as the savior of homeopathy. I have shown that he was because of his inclusion of the Homeopathic Pharmacopeia in the Food, Drug, and Cosmetic Act of 1938. Copeland never forgot he was a homeopath.
Q: You are a cancer survivor and have been in remission for several years–brought about by conventional, not alternative medicines. After seeing how successful conventional medicine can be, how are you able to take such an even-handed look at alternative medicine?
First of all I need to emphasize that there is no alternative medicine that can treat — much less cure — cancer. Not a single alternative cancer treatment has ever been scientifically confirmed. Cancer patients should stay far, far away from anything alternative. ( My beloved sister-in-law lost a whole summer of good, conventional cancer treatment that was keeping her very advanced ovarian cancer at bay when she plunked down $10,000 to a man living somewhere in the west who claimed he could cure her in just one month. Fortunately, she soon saw the light (although her pocketbook remained light) and she returned to her standard doctor who kept her alive for another two years!)
Now, having said that, let me explain that taking an even-handed look at things is not only part of my nature but my main objective as a writer. I am very proud of the fact that one of my books received praise from both Victor Navasky, the publisher of the leftist Nation, and William F. Buckley, Jr, the founder of the conservative National Review. And as many people do, I have friends who are Republicans and friends who are Democrats, friends who are liberal and friends who are conservative, friends who are religious and friends who are atheists. All in all, being fair-minded and objective often seems like a gift to me, one that not only enables me to be a better listener, but one that gives me the freedom to explore the many possibilities that exist in all subjects.
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