Netflix: a good source of entertainment, not a good source of medical information
Netflix recently produced a reprehensible documentary series on “The Goop Lab”. It amounted to an advertisement for Gwyneth Paltrow’s unscientific approach to wellness and a paean to gullibility. It takes on psychedelic mushrooms, breathing techniques to develop cold tolerance, achieving orgasm, anti-aging claims, energy healing, and intuition (including communicating with the dead). All are presented in a “gee whiz” fashion with no discussion of actual evidence and no input from skeptics. When I heard that another new Netflix documentary, (Un)Well would feature both pros and cons for various alternative medicine modalities, I hoped for something more balanced. As I watched it, my hopes were promptly crushed. I’m sure they meant well, and they made an effort to follow the journalistic mantra of fairly presenting both sides of controversial issues, but they failed miserably.
Each episode begins with the message that it is designed to entertain and inform, not to provide medical advice. They ask, “Wellness: does it bring health and healing, or are we falling victim to false promises?” But they don’t answer that question. The “evidence” for health and healing is purely anecdotal, presented by credulous patients and practitioners, often charismatic individuals whose beliefs are presented through emotional stories that tug at the heartstrings. These hopeful stories alternate with more sober statements by experts saying that the evidence for effectiveness just isn’t there and the treatments are often harmful, but these segments are shorter and mostly presented by less charismatic individuals. I think the average viewer is likely to remember the enthusiasm of the believers, discount the warnings, and want to try the treatment for themselves, “just in case”.
They make a big point of how widespread and profitable the wellness industry has become, so it would seem logical to tackle the most popular and most profitable modalities. They might have started with chiropractic, acupuncture, homeopathy, herbal medicines, naturopathy, and energy medicine. In fact, those are the ones I covered in my YouTube lecture series. Instead, they took on these topics:
- Essential oils
- Tantric sex
- Adults drinking breast milk
- Fasting
- Ayahuasca
- Bee sting therapy
I find their selection of topics irrational and bizarre. I can’t help but wonder how they chose them.
In the first place, is there really a controversy between anecdotal reports and rigorous scientific studies? If so, it’s only in the public imagination. Scientists, doctors, and critical thinkers understand that testimonials are not evidence; the only reliable way to find out if a treatment is effective and safe is to test it in controlled clinical trials. The people who made (Un)Well seem to believe testimonials and hearsay are good evidence and are just as credible as scientific studies, perhaps even more so.
I’m going to cover Episode 1 on essential oils in detail to give you a feel for their approach, and then I will offer briefer comments on the other five episodes.
Episode 1: Essential oils
They start by saying essential oils used to be “pretty fringe”, but now they are appearing everywhere, and aromatherapy has become a multibillion-dollar industry.
They showcase several advocates of aromatherapy. First, an integrative nurse who got certified in clinical aromatherapy after over a year’s study. She tells us she has seen aromatherapy work.
Next is the mother of a teenage girl diagnosed with autism at age 4. She consults an aromatherapist who specializes in treating children with special needs and who used essential oils to calm her own autistic son and to help him sleep. The aromatherapist says, “I know what the oils are capable of”.
Then we hear from a chiropractor who thinks becoming a Christian produced a miraculous resolution of multiple health problems and who shows how his family of six uses essential oils for everything. He believes essential oils are effective for many things, says he has seen them cure cancer, and claims to have helped millions. But he protests that the FDA has made it illegal for him to make those claims. For that reason, he doesn’t sell essential oils, but he does run a profitable business and podcast recommending them.
After these testimonials, we hear from a less charismatic PhD expert who says, “There’s not the clinical evidence”. But she leaves a loophole, saying that essential oils don’t cure but may help people cope.
Next, a DoTerra distributor credits essential oils with saving her life after surgery failed to completely remove her brain tumor. She claims there is an essential oil for 99.9% of health problems. They help clean out the blood in the outside part of the cell (what does that mean?). Citrus oils make you happy, peppermint oil relieves headaches, and frankincense is really good for cancer. She says the FDA doesn’t like essential oils and prevents her from making claims that might take profits away from Big Pharma. She says essential oils are safer, cheaper, and more effective than conventional medical care. She sees miracle stories from so many people. She has recruited a team of 16,000 and has developed her business to achieve a six-figure income from DoTerra. She talks to a woman she recruited who is not yet making a profit but still believes it is “the best career on the planet”.
Next, a segment about the other essential oils multilevel marketing companies shows the Young Living Convention, complete with Gary Young’s bizarre shenanigans, pyrotechnic displays, and a jam-packed convention center full of super-enthusiastic disciples. After Gary Young’s spinal column was “ruptured” he was told he would never walk again, but he recovered from his spinal injury after subsisting on nothing but lemon juice and water for over 200 days, followed by extensive rehabilitation. After being sued for harming a patient, he moved to Ecuador where the laws were more lenient. He got away with giving essential oils to patients intravenously and performing gallbladder surgery without a medical license. He believed essential oils had miraculous healing properties. You can read about the dubious claims of aromatherapy on Quackwatch and you can read about Gary Young here, where he is described as an uneducated huckster with a track record of arrests for health fraud. (Un)Well doesn’t tell you about all that; instead, it shows all those thousands of enthusiastic supporters cheering for him at his Young Living convention.
A former Young Living distributor says she is one of hundreds of thousands of women who have been taken advantage of by Young Living. A lawyer who filed a class action suit says Young Living is an illegal pyramid scheme. One of the plaintiffs explains that you don’t get income from selling the oils, but by recruiting other distributors, and you don’t get paid unless you also commit to buying $100 of products every month. She kept accumulating an inventory that she was unable to sell. If you reach the level of Royal Crown Diamond, you are making $1.8 million a year; but only 46 people have ever reached that level. That’s 0.0015% of members. 94% of members averaged an income of $1.00 a month; most lost money. One of the most insidious effects is the collateral damage. Members recruit family, friends, and neighbors, and when the house of cards collapses, it harms all of those people. It is a predatory enterprise.
Another ex-distributor explains how she was “brainwashed”. They told her the oils were so pure they could be taken internally (as if “purity” meant “safety”), and she used them in many ways until she developed a skin rash. She was told it couldn’t be the oils, but it might mean her body was detoxing, so she treated herself with more oils. She ended up with a total body rash, swelling that made it impossible to bend her limbs, and oozing liquid from the affected areas. She sent photos to the company to be shared with the chief medical officer, but never got a response. When she made her story public, she heard from many other women who had experienced similarly devastating allergic reactions.
Finally, we go back to the autistic teen. Her mother thinks the essential oils have improved her sleep and decreased her fussiness, and she even used the word “and” in a sentence for the first time. But she is shown flapping her hands in typical autistic fashion. Mom says essential oils are not the be-all, end-all, but have been valuable tools that have “empowered” the family and put them in a better place.
Episode 2: Tantric sex
They feature therapists who are teaching people to love themselves and to have total body orgasms and clients who claim the therapy transformed their lives. They say nobody knows what Tantra is, but it is said to be anything and everything. An expert on religions points out that modern sex therapy is a perversion of the original philosophy of Tantra and calling what they do Tantra is cultural appropriation. We hear about tantric gurus sexually abusing disciples.
Episode 3: Adults drinking breast milk
They feature a man who is convinced breast milk cured his prostate cancer and another who drinks it for body-building. They talk about where you can buy breast milk, and as a counterpoint they mention a study that analyzed breast milk samples and found that many were so contaminated with bacteria that they compared it to sewage.
Episode 4: Fasting
They describe several ways to practice partial or intermittent fasting but spend the most time on people who go on supervised water-only fasts for up to a month. Testimonials from clients describe wonderful results, but they do mention one man who died.
Episode 5: Ayahuasca
Ayahuasca is a plant-derived hallucinogenic drug discovered by Indians in the Amazon jungle. The original practice was for a sick person to consult a shaman; the shaman took ayahuasca to access another reality where he learned knowledge to help the patient. In the modern iteration, the patients take ayahuasca themselves. Some travel to the Amazon; ayahuasca is illegal in the US, but some people get around the law by calling it a sacrament of their church (which they created for the sole purpose of obtaining ayahuasca). They drink the foul-tasting liquid, become violently nauseated, vomit repeatedly, then have bizarre hallucinations. Patients claim it was a life-altering experience, with miraculous results such as curing drug and alcohol addiction.
Episode 6: Bee sting therapy
Apitherapists claim bee stings have many health benefits: they are allegedly effective for arthritis, chronic Lyme disease (which doesn’t exist), and much more, even cancer. This episode at least featured a noted skeptic, our own Dr. Steve Novella, who did a creditable job of explaining what the scientific studies have found and why the evidence is lacking. Unfortunately, his segment is immediately followed by a bee sting therapist talking about why bee stings are so powerful (completely disregarding the fact that Novella just said they aren’t). They do mention the danger of allergy and anaphylaxis and the need to have an EpiPen handy even if the patient has been stung many times before with no reaction. But the final segment, likely to stick in the viewer’s mind, is an extensive demonstration of how a patient can order live bees and apply them to her own skin. The featured patient feels sorry for the bees and cries because they have to die.
Whiplash
These documentaries were enough to induce whiplash. They jerked me back and forth between enthusiastic endorsements and sober but rather boring warnings until I hardly knew what to think. There were no transitions and no attempt to reconcile the contradictory information.
What is missing
They made no attempt to explain how science should be used to test whether a treatment is effective. They did not explain the many psychological factors that lead people to falsely conclude that ineffective treatments are effective. As I watched the episodes, I could think of many other explanations for what people thought they had observed. Just for one example, autism is a developmental delay, not a total absence of development. We have no way of knowing that the teenage girl wouldn’t have made the same improvements over the same period of time without the essential oils but with a similar amount of attention. They did not attempt to describe the placebo phenomenon, or regression to the mean, or the natural course of illness, or spontaneous regression, or the post hoc ergo propter hoc fallacy.
Rather than helping us understand those other possibilities, (Un)Well lets us assume the treatments must have been effective, the anecdotes must have been good evidence, and despite naysayers and the scientific evidence from studies, the treatment might still be worth trying, especially if you are desperate and conventional medicine has not helped you.
Unfortunate messages
They frequently criticize science-based medicine and let viewers assume they can dispense with drugs and cancer therapies and turn to “more effective” natural remedies. They endorse conspiracy theories and indulge in the sport of “doctor bashing”. They feature “experts” who are often chiropractors, naturopaths, and people with little or no medical training. They seldom feature actual MDs and qualified experts. They mention homeopathy, acupuncture, and other non-science-based therapies without a word of criticism, as if they were effective mainstream therapies that have been proven to work. They tell us an untested treatment is effective for a bogus disease, chronic Lyme. They claim not to offer medical advice, but their message is likely to tempt viewers to reject effective treatments in favor of untested and possibly dangerous ones. This could potentially do a lot of harm.
Conclusion: Gives the illusion of balance but misses the mark
They could have offered other plausible explanations for the perceptions of healing. They could have educated viewers about all the ways people come to believe ineffective treatments work, and about the fact that controlled studies are needed to test beliefs against reality. They could have tried to reconcile the opposite conclusions of the “pro” and “con” segments, instead of mindlessly jerking us back and forth between the two without any transition, explanation, or comment. Rather than explaining science, they offer slick journalism, appeals to emotion, and unthinking gullibility. The best journalism aims to inform, educate, and make a better world. This Netflix series is not good journalism. It is biased and will undoubtedly mislead many viewers. Two thumbs down.